Larusso, Mark Anthony

Larusso, Mark Anthony is an individual health care provider with primary practice located at 1647 Taussig Boulevard Naval Dental Clinic Norfolk, Norfolk VA 23511-2896. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Larusso, Mark Anthony can be contacted via phone (757) 953-8698.

Contact Information

Primary practice address
1647 Taussig Boulevard Naval Dental Clinic Norfolk Norfolk VA 23511-2896
Phone: (757) 953-8698
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 0401411249 Virginia
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X Illinois

Profile Details

NPI number 1558358960
LBN Legal business name Larusso, Mark Anthony
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Sep 5th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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