Provider Demographics
NPI:1730350273
Name:CARUSO, DEBORAH A (DDS)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:CARUSO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 WEST ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4055
Mailing Address - Country:US
Mailing Address - Phone:410-990-4800
Mailing Address - Fax:410-990-4869
Practice Address - Street 1:1610 WEST ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4055
Practice Address - Country:US
Practice Address - Phone:410-990-4800
Practice Address - Fax:410-990-4869
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10561122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist