Provider Demographics
NPI:1336475680
Name:AURINA POH-MATACIO, DDS, INC
Entity Type:Organization
Organization Name:AURINA POH-MATACIO, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AURINA
Authorized Official - Middle Name:
Authorized Official - Last Name:POH-MATACIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:707-963-4611
Mailing Address - Street 1:995 DOWDELL LN
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574-1451
Mailing Address - Country:US
Mailing Address - Phone:707-963-4611
Mailing Address - Fax:707-963-1436
Practice Address - Street 1:995 DOWDELL LN
Practice Address - Street 2:
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-1451
Practice Address - Country:US
Practice Address - Phone:707-963-4611
Practice Address - Fax:707-963-1436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA527711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty