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2831 Midway Rd Se Ste 116 Bolivia NC 28422-8377 | |
| (910) 408-4436 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2831 Midway Rd Se Ste 116, Bolivia, North Carolina |
| Authorized Official Name and Position | Michael Riccobene (OWNER) |
| Authorized Official Contact | 9198536172 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 749625 Atlanta GA 30374-9625 Ph: () - | 2831 Midway Rd Se Ste 116 Bolivia NC 28422-8377 Ph: (910) 408-4436 |
| NPI Number | 1023616596 |
|---|---|
| Provider Enumeration Date | 10/15/2020 |
| Last Update Date | 11/16/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023616596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Harrington & Wilharm, Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3071 Southport Supply Rd Se, Bolivia, NC 28422 Phone: 910-253-0000 Fax: 910-253-6023 | |