Riccobene & Associates I, DDS, P.A.
Dentist, General Practice in Bolivia, NC. Organization (NPI-2).
NPI number1023616596
StatusActive
Last updated in NPPESNov 16, 2023
Details
- NPI
- 1023616596
- Entity type
- Organization (NPI-2)
- Legal business name
- Riccobene & Associates I, DDS, P.A.
- Organization subpart
- No
- Enumeration date
- Oct 15, 2020
- Certification date
- Nov 16, 2023
- Last updated
- Nov 16, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Riccobene Associates Family Dentistry- Southport (Doing Business As)
Practice location
2831 Midway Rd Se Ste 116Bolivia, NC 28422-8377
Phone 910-408-4436
Mailing address
Po Box 749625Atlanta, GA 30374-9625
Authorized official
Michael Riccobene
Owner
9198536172
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Other General Practice Dentistry providers in Bolivia, NC
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