| NPI | 1699549857 |
|---|---|
| Doing Business As | COMMONWEALTH SPECIALTY - COLONIAL HEIGHTS PEDS |
| Entity Type | Organization |
| Authorized Contact | MICHAEL RICCOBENE CEO 910-853-6172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2024-08-02 |