Individual
SAM REISER CARUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2230 TOWNE LAKE PKWY, BLDG 1000, STE 110, WOODSTOCK, GA 30189
(770) 672-5629
Mailing address
85 GOLF CREST DR STE 209, ACWORTH, GA 30101-2698
(770) 672-5629
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN123254
GA
390200000X
Student in an Organized Health Care Education/Training Program
DRP2199
FL
Other
Enumeration date
04/16/2020
Last updated
04/20/2026
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