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General NPI Number Information
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NPI Number | 1275567232
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Entity Type | Individual
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Provider Name | MARY PAULINE PUNO D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 EMBARCADERO CTR LBBY LEVEL
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City | SAN FRANCISCO
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State | CA
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Zip | 94111-3627
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Country | US
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Telephone | 415-421-4772
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Fax | 415-421-1467
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Provider Business Mailing Address
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Address Line | 82 NORTHCREST DR
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-7313
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Country | US
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Telephone | 415-823-8218
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 50814
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License Number State | CA
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