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General NPI Number Information
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NPI Number | 1881601656
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Entity Type | Individual
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Provider Name | RALPH PATRICK LUONGO JR. DDS
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | W3275 WOLF RIVER DR
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City | KESHENA
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State | WI
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Zip | 54135-9202
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Country | US
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Telephone | 715-799-3960
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Fax |
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Provider Business Mailing Address
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Address Line | W3275 WOLF RIVER DR
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City | KESHENA
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State | WI
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Zip | 54135-9202
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Country | US
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Telephone | 715-799-3960
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4802
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5561
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DD3700
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6001279-15
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License Number State | WI
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