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General NPI Number Information
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NPI Number | 1821670282
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Entity Type | Organization
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Legal Business Name | RICCOBENE & ASSOCIATES I, DDS, P.A.
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Dates
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Enumeration Date | 04/26/2021
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 1829 S RIDGE AVE
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City | KANNAPOLIS
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State | NC
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Zip | 28083-6149
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Country | US
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Telephone | 704-938-4211
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Fax |
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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 | 919-585-5205
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Fax |
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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 | 919-853-6172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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