# RICCOBENE & ASSOCIATES LIII, DDS, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Airlie Oral Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336898675
- **Authorized official:** MICHAEL RICCOBENE (OWNER)
- **Authorized official phone:** (919) 585-5205

## Contact information

- **Practice address:** 2001 S BAXTER DR, LELAND, NC 28451-0139
- **Practice address phone:** (910) 769-1605
- **Mailing address:** 2001 S BAXTER DR, LELAND, NC 28451-0139

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 03/23/2022
- **Last updated:** 10/20/2023