| Commonwealth Dentistry - Suffolk | |
|
2003 Meade Pkwy Suffolk VA 23434-4259 | |
| (757) 514-3656 | |
| Not Available |
| Full Name | Commonwealth Dentistry - Suffolk |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2003 Meade Pkwy, Suffolk, Virginia |
| Authorized Official Name and Position | Michael Riccobene (OWNER) |
| Authorized Official Contact | 9108536172 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Dentistry - Suffolk Po Box 749632 Atlanta GA 30374-9632 Ph: (919) 439-3331 | Commonwealth Dentistry - Suffolk 2003 Meade Pkwy Suffolk VA 23434-4259 Ph: (757) 514-3656 |
| NPI Number | 1285398271 |
|---|---|
| Provider Enumeration Date | 10/26/2021 |
| Last Update Date | 08/02/2024 |
| Certification Date | 08/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285398271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
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