Provider Demographics
NPI:1043344641
Name:AMATO, RICHARD F (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:F
Last Name:AMATO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 ELM ST
Mailing Address - Street 2:SUITE 103A
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-2280
Mailing Address - Country:US
Mailing Address - Phone:203-268-2000
Mailing Address - Fax:203-268-2362
Practice Address - Street 1:324 ELM ST
Practice Address - Street 2:SUITE 103A
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-2280
Practice Address - Country:US
Practice Address - Phone:203-268-2000
Practice Address - Fax:203-268-2362
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0066521223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics