Provider Demographics
NPI:1881848786
Name:AMATO, PAUL R (DDS, FAGD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:R
Last Name:AMATO
Suffix:
Gender:M
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 MADISON STREET
Mailing Address - Street 2:SUITE 1230
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:206-626-5400
Mailing Address - Fax:206-447-0101
Practice Address - Street 1:1101 MADISON STREET
Practice Address - Street 2:SUITE 1230
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-626-5400
Practice Address - Fax:206-447-0101
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 000096601223G0001X
WADE000096601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice