Provider Demographics
NPI:1154511186
Name:POH MATACIO, AURINA GEK HONG (DDS)
Entity Type:Individual
Prefix:
First Name:AURINA
Middle Name:GEK HONG
Last Name:POH MATACIO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 DOWDELL LANE
Mailing Address - Street 2:
Mailing Address - City:ST HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574
Mailing Address - Country:US
Mailing Address - Phone:707-963-4611
Mailing Address - Fax:707-963-1436
Practice Address - Street 1:995 DOWDELL LANE
Practice Address - Street 2:
Practice Address - City:ST HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574
Practice Address - Country:US
Practice Address - Phone:707-963-4611
Practice Address - Fax:707-963-1436
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52771122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist