# RICCOBENE & ASSOCIATES CCCI, DDS, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Edgewater Oral and Maxillofacial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891625265
- **Authorized official:** MICHAEL RICCOBENE DDS (CEO)
- **Authorized official phone:** (910) 853-6172

## Contact information

- **Practice address:** 900 HIGHWAY 17 S STE C, NORTH MYRTLE BEACH, SC 29582-1904
- **Practice address phone:** (843) 491-6021
- **Mailing address:** PO BOX 749625, ATLANTA, GA 30374-9625

## 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:** 05/19/2026
- **Last updated:** 05/19/2026