Provider Demographics
NPI:1326248741
Name:AMATO, EMANUEL S (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMANUEL
Middle Name:S
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 1:831 E FERN DR S
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-3249
Mailing Address - Country:US
Mailing Address - Phone:602-626-5443
Mailing Address - Fax:
Practice Address - Street 1:4080 W RAY RD
Practice Address - Street 2:SUITE 21
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-7262
Practice Address - Country:US
Practice Address - Phone:480-413-1100
Practice Address - Fax:480-413-1101
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD6794122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist