Provider Demographics
NPI:1922046879
Name:CARUSO, ANTHONY JAMES JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JAMES
Last Name:CARUSO
Suffix:JR
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 1:3234 HOAGLAND BLACKSTUB RD
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-9171
Mailing Address - Country:US
Mailing Address - Phone:330-637-1402
Mailing Address - Fax:
Practice Address - Street 1:4466 DARROW RD
Practice Address - Street 2:SUITE 16
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1866
Practice Address - Country:US
Practice Address - Phone:330-688-3115
Practice Address - Fax:330-688-3304
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-02-0590122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist