# RICCOBENE & ASSOCIATES CC, DDS, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Commonwealth Dentistry - Palmyra
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326701764
- **Authorized official:** MICHAEL RICCOBENE (OWNER)
- **Authorized official phone:** (910) 853-6172

## Contact information

- **Practice address:** 40 JOSHUA LN, PALMYRA, VA 22963-6208
- **Practice address phone:** (434) 589-5327
- **Mailing address:** PO BOX 749632, ATLANTA, GA 30374-9632
- **Mailing address phone:** (919) 585-5205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/21/2021
- **Last updated:** 08/02/2024