Provider Demographics
NPI:1811980956
Name:AMARO, AMY D (DMD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:D
Last Name:AMARO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MYSTIC HILL RD
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-3071
Mailing Address - Country:US
Mailing Address - Phone:860-245-0766
Mailing Address - Fax:
Practice Address - Street 1:5 CHURCH LN
Practice Address - Street 2:SUITE #3
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1621
Practice Address - Country:US
Practice Address - Phone:860-691-0511
Practice Address - Fax:860-739-9599
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0087821223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics