Organization
RICCOBENE & ASSOCIATES CCII, DDS, PC
Active
Other names
Commonwealth Specialty - Suffolk
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RICCOBENE (CEO)
(910) 853-6172
Entity
Organization
Contact information
Practice address
2003 MEADE PKWY, SUFFOLK, VA 23434-4259
(757) 514-3656
Mailing address
PO BOX 749632, ATLANTA, GA 30374-9632
(757) 514-3656
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
11/08/2023
Last updated
08/02/2024
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