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NPI Code Detail

MEDICARE: RICCOBENE & ASSOCIATES I, DDS, P.A.

MEDICARE: RICCOBENE & ASSOCIATES I, DDS, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1245536218
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICCOBENE & ASSOCIATES I, DDS, P.A.
Provider Business Mailing Address
First Line : PO BOX 749625
Second Line :
City : ATLANTA
State : GA
Zip : 30374-9625
Country : US
Telephone Number : 919-556-6666
Fax Number :
Provider Business Practice Location Address
First Line : 13251 FALLS OF NEUSE RD STE 141
Second Line :
City : RALEIGH
State : NC
Zip : 27614-8573
Country : US
Telephone Number : 919-556-6666
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MICHAEL RICCOBENE
Credential :
Telephone Number : 855-417-4226
Provider Enumeration Date : 02/08/2011
Last Update Date : 09/26/2024

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