Individual
DR. RONALD MILTON LONGANECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
821 MARTIN RD, AMARILLO, TX 79107-6813
(806) 376-4770
Mailing address
PO BOX 51436, AMARILLO, TX 79159-1436
(806) 376-4770
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
8550
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40011733
DEPT. OF PUBLIC SAFETY
TX
Enumeration date
08/21/2006
Last updated
07/09/2007
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