Individual
MRS. TRACEY LEE AMATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
330 WETHERSFIELD AVE OFC, HARTFORD, CT 06114-1409
(606) 958-8548
Mailing address
330 WETHERSFIELD AVE OFC, HARTFORD, CT 06114-1409
(606) 958-8548
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
005024
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19090120
DR. DOUGLAS MACGILPIN
CT
Enumeration date
11/07/2022
Last updated
11/07/2022
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