Organization
RICCOBENE & ASSOCIATES CCII, DDS, PC
Active
Other names
Commonwealth Specialty - Colonial Heights
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RICCOBENE (CEO)
(910) 853-6172
Entity
Organization
Contact information
Practice address
456 CHARLES H DIMMOCK PKWY STE 5, COLONIAL HEIGHTS, VA 23834-2936
(804) 520-4288
Mailing address
PO BOX 749632, ATLANTA, GA 30374-9632
(919) 585-5205
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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