Healthcare Provider Details

I. General information

NPI: 1952804767
Provider Name (Legal Business Name): ALISON MARIE CARUSO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2018
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WHETSTONE PL STE 308
ST AUGUSTINE FL
32086-5775
US

IV. Provider business mailing address

100 WHETSTONE PL STE 308
ST AUGUSTINE FL
32086-5775
US

V. Phone/Fax

Practice location:
  • Phone: 904-299-7997
  • Fax:
Mailing address:
  • Phone: 904-299-7997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN28935
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN1857874
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: