=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740308790
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FRANK AMATO, DMD, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 129 JOHNSON RD SUITE 6
-----------------------------------------------------
City | TURNERSVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08012-1777
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-401-8500
-----------------------------------------------------
Fax | 856-401-8509
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 129 JOHNSON RD SUITE 6
-----------------------------------------------------
City | TURNERSVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08012-1777
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-401-8500
-----------------------------------------------------
Fax | 856-401-8509
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. FRANK AMATO
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 856-401-8500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 22DI01839100
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------