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General NPI Number Information
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NPI Number | 1922046879
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Entity Type | Individual
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Provider Name | ANTHONY JAMES CARUSO JR. D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 4466 DARROW RD SUITE 16
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City | STOW
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State | OH
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Zip | 44224-1866
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Country | US
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Telephone | 330-688-3115
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Fax | 330-688-3304
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Provider Business Mailing Address
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Address Line | 3234 HOAGLAND BLACKSTUB RD
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City | CORTLAND
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State | OH
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Zip | 44410-9171
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Country | US
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Telephone | 330-637-1402
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30-02-0590
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License Number State | OH
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