Provider Demographics
NPI:1790826303
Name:AMATO, FRANCIS XAVIER III (DMD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:XAVIER
Last Name:AMATO
Suffix:III
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 1:200 HOSPITAL AVE SUITE 1
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28640
Mailing Address - Country:US
Mailing Address - Phone:336-246-7473
Mailing Address - Fax:336-846-4895
Practice Address - Street 1:4 CRESCENT DRIVE
Practice Address - Street 2:
Practice Address - City:WEST JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28694
Practice Address - Country:US
Practice Address - Phone:336-246-7473
Practice Address - Fax:336-846-4895
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7857122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
9022GOtherBLUE CROSS BLUE SHIELD
9022GOtherBLUE CROSS BLUE SHIELD