Provider Demographics
NPI:1699976860
Name:ARDUENGO, RICARDO (DMD)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:ARDUENGO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 W JERSEY ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-1364
Mailing Address - Country:US
Mailing Address - Phone:908-289-4646
Mailing Address - Fax:
Practice Address - Street 1:230 W JERSEY ST
Practice Address - Street 2:SUITE 108
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-1364
Practice Address - Country:US
Practice Address - Phone:908-289-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1389101122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist