| NPI | 1699423251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RICCOBENE Owner 919-853-6172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2023-11-16 |