Provider Demographics
NPI:1760472559
Name:AMATO, STEVEN M (DDS, MS, SC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:AMATO
Suffix:
Gender:M
Credentials:DDS, MS, SC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 E WALDO BLVD
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-2905
Mailing Address - Country:US
Mailing Address - Phone:920-684-7103
Mailing Address - Fax:
Practice Address - Street 1:17 E WALDO BLVD
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-2905
Practice Address - Country:US
Practice Address - Phone:920-684-7103
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI00046081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics