Provider Demographics
NPI:1487009031
Name:AMATULI, ROBERT JR
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:AMATULI
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 BEARDS HILL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-2295
Mailing Address - Country:US
Mailing Address - Phone:410-306-6040
Mailing Address - Fax:
Practice Address - Street 1:1013 BEARDS HILL RD STE 100
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2295
Practice Address - Country:US
Practice Address - Phone:410-306-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16289122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist