Provider Demographics
NPI:1356487128
Name:GENE B. POON, DDS, INC.
Entity Type:Organization
Organization Name:GENE B. POON, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:POON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-397-1600
Mailing Address - Street 1:728 PACIFIC AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-4457
Mailing Address - Country:US
Mailing Address - Phone:415-397-1600
Mailing Address - Fax:
Practice Address - Street 1:728 PACIFIC AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-4457
Practice Address - Country:US
Practice Address - Phone:415-397-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA338321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty