Individual
DIANE V CARUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
200 W FRONT ST STE 304, BLOOMINGTON, IL 61701-5067
(309) 888-5454
(309) 888-5896
Mailing address
200 W FRONT ST STE 304, BLOOMINGTON, IL 61701-5067
(309) 888-5454
(309) 888-5896
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
04/08/2008
Last updated
04/08/2008
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