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General NPI Number Information
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NPI Number | 1336475680
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Entity Type | Organization
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Legal Business Name | AURINA POH-MATACIO, DDS, INC
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Dates
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Enumeration Date | 10/21/2009
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Last Update Date | 10/21/2009
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Provider Practice Location Address
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Address Line | 995 DOWDELL LN
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City | SAINT HELENA
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State | CA
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Zip | 94574-1451
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Country | US
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Telephone | 707-963-4611
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Fax | 707-963-1436
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Provider Business Mailing Address
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Address Line | 995 DOWDELL LN
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City | SAINT HELENA
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State | CA
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Zip | 94574-1451
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Country | US
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Telephone | 707-963-4611
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Fax | 707-963-1436
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Authorized Official
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Title or Position | OWNER
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Name | DR. AURINA POH-MATACIO
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Credential | DDS
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Telephone | 707-963-4611
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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 | 52771
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License Number State | CA
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