Provider Demographics
NPI:1992870570
Name:RICHARD L SEARS THOMAS N CARUSO DDS PC
Entity type:Organization
Organization Name:RICHARD L SEARS THOMAS N CARUSO DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST VICE PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:N
Authorized Official - Last Name:CARUSO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:315-942-4514
Mailing Address - Street 1:3 SCHUYLER ST
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13309
Mailing Address - Country:US
Mailing Address - Phone:315-942-4514
Mailing Address - Fax:315-942-3572
Practice Address - Street 1:3 SCHUYLER ST
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:NY
Practice Address - Zip Code:13309
Practice Address - Country:US
Practice Address - Phone:315-942-4514
Practice Address - Fax:315-942-3572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04028122300000X
NY039384122300000X
NY046947-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty