| NPI | 1114681103 |
|---|---|
| Doing Business As | COMMONWEALTH DENTISTRY - MIDLOTHIAN |
| Entity Type | Organization |
| Authorized Contact | MICHAEL RICCOBENE Owner 910-853-6172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2024-08-02 |