Provider Demographics
NPI:1235324286
Name:CARUSO, VINCENT FRANK (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:FRANK
Last Name:CARUSO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 ORIENT WAY
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2082
Mailing Address - Country:US
Mailing Address - Phone:201-531-0840
Mailing Address - Fax:201-531-0928
Practice Address - Street 1:47 ORIENT WAY
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-2082
Practice Address - Country:US
Practice Address - Phone:201-531-0840
Practice Address - Fax:201-531-0928
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI17110122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist