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NPI Code Detail

MEDICARE: DR. DONALD A AMARO DDS

MEDICARE: DR. DONALD A AMARO DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0106XOral and Maxillofacial Pathology Dentistry004073CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15477144OTHERCTAETNA MEDICAL PROVIDER ID
2020004073CT01OTHERCTBC/BS PROVIDER ID #

General Provider Information

NPI Number : 1164416699
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD A AMARO DDS
Provider Business Mailing Address
First Line : 130 NEW LONDON TPKE
Second Line :
City : NORWICH
State : CT
Zip : 06360-2624
Country : US
Telephone Number : 860-886-0651
Fax Number : 860-823-1577
Provider Business Practice Location Address
First Line : 130 NEW LONDON TPKE
Second Line :
City : NORWICH
State : CT
Zip : 06360-2624
Country : US
Telephone Number : 860-886-0651
Fax Number : 860-823-1577
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 04/09/2008

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