NPI | 1073243580 |
---|---|
Doing Business As | COMMONWEALTH ORTHODONTICS COLONIAL HEIGHTS |
Entity Type | Organization |
Authorized Contact | MICHAEL RICCOBENE Owner 910-853-6172 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2022-06-16 |
Last Update Date | 2024-08-02 |