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Dominic Jacob Dirusso, DDS Valid NPI

Individual provider · General Practice Dentistry · Flower Mound, TX

NPI
1518670959
Type
Individual (Type 1)
Primary specialty
General Practice Dentistry (Dentist)
Specialty group
Dental Providers
Taxonomy code
1223G0001X
License number
38883 (TX)
Sex
Male
Sole proprietor
Yes
Enumerated
2022-12-30
Last updated
2022-12-30
Practice location
1450 Long Prairie Rd, Ste 160
Flower Mound, TX 75028
(469) 293-2220

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