Organization
RICCOBENE & ASSOCIATES CC, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RICCOBENE (CEO)
(910) 853-6172
Entity
Organization
Contact information
Practice address
68 HERITAGE DR STE 5, PALMYRA, VA 22963-2662
(434) 443-5722
Mailing address
3434 KILDAIRE FARM RD STE 350, CARY, NC 27518-2205
(919) 439-3331
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
11/10/2021
Last updated
08/02/2024
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