Diane V Caruso, DDS
Dentist, General Practice in Bloomington, IL. Individual provider (NPI-1).
NPI number1982877288
StatusActive
Last updated in NPPESApr 8, 2008
Details
- NPI
- 1982877288
- Entity type
- Individual (NPI-1)
- Name
- Diane V Caruso
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 8, 2008
- Last updated
- Apr 8, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 019020945 | IL | Yes |
Practice location
200 W Front St Ste 304Bloomington, IL 61701-5067
Phone 309-888-5454 · Fax 309-888-5896
Mailing address
200 W Front St Ste 304Bloomington, IL 61701-5067
Phone 309-888-5454 · Fax 309-888-5896
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