# PATTY,LYBRAND & RICCIUTTI DDS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861534950
- **Authorized official:** SUSAN GRIFFIN (AUTHORIZED OFFICIAL / OFFICE MANAGE)
- **Authorized official phone:** (704) 291-7333

## Contact information

- **Practice address:** 10801 WOODLAND BEAVER RD STE 103, CHARLOTTE, NC 28215-5177
- **Practice address phone:** (704) 291-7333
- **Mailing address:** 1851 WELLNESS BLVD, MONROE, NC 28110-7774
- **Mailing address phone:** (704) 291-7333
- **Mailing address fax:** (704) 292-1203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 5322 | NC | Yes |

## Other

- **Enumeration date:** 02/13/2007
- **Last updated:** 05/07/2024