Provider Demographics
NPI:1225109028
Name:AMATO, ANTHONY VINCENT (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:VINCENT
Last Name:AMATO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 N MAIN ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1970
Mailing Address - Country:US
Mailing Address - Phone:860-561-3050
Mailing Address - Fax:860-561-5312
Practice Address - Street 1:18 N MAIN ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1970
Practice Address - Country:US
Practice Address - Phone:860-561-3050
Practice Address - Fax:860-561-5312
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT73171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice