Individual
DR. MARK DIRUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1201 N STONEWALL AVE, OKLAHOMA CITY, OK 73117-1214
(405) 271-7744
Mailing address
25 BUXTON LN, RIVERSIDE, CT 06878-1601
(914) 552-8591
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8111
OK
Other
Enumeration date
05/21/2025
Last updated
07/28/2025
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