Provider Demographics
NPI:1053505651
Name:ROOT CANAL SPECIALISTS, P.C.
Entity Type:Organization
Organization Name:ROOT CANAL SPECIALISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:D
Authorized Official - Last Name:AMARO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:860-691-0511
Mailing Address - Street 1:5 CHURCH LN
Mailing Address - Street 2:SUITE #3
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1621
Mailing Address - Country:US
Mailing Address - Phone:860-691-0511
Mailing Address - Fax:860-739-9599
Practice Address - Street 1:5 CHURCH LN
Practice Address - Street 2:SUITE #3
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1621
Practice Address - Country:US
Practice Address - Phone:860-691-0511
Practice Address - Fax:860-739-9599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty