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General NPI Number Information
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NPI Number | 1043844871
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Entity Type | Organization
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Legal Business Name | RICCOBENE & ASSOCIATES XIII, DDS, P.A.
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Dates
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Enumeration Date | 03/02/2020
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 6950 NEXUS CT
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-2642
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Country | US
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Telephone | 910-864-2400
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Fax | 910-864-3016
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Provider Business Mailing Address
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Address Line | PO BOX 749625
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City | ATLANTA
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State | GA
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Zip | 30374-9625
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Country | US
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Telephone | 910-864-2400
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Fax | 910-864-3016
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL RICCOBENE
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Credential |
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Telephone | 855-417-4226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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