Organization
RICCOBENE & ASSOCIATES CCII, DDS, PC
Active
Other names
Commonwealth Specialty - Forest Hill
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RICCOBENE (CEO)
(910) 853-6172
Entity
Organization
Contact information
Practice address
6750 FOREST HILL AVE STE B, RICHMOND, VA 23225-1802
(804) 532-4993
Mailing address
PO BOX 749632, ATLANTA, GA 30374-9632
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
08/02/2024
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