| |
12244 Wake Union Church Rd Wake Forest NC 27587-9549 | |
(919) 556-2997 | |
Not Available |
Full Name | |
---|---|
Speciality | Dentist - General Practice |
Location | 12244 Wake Union Church Rd, Wake Forest, 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: () - | 12244 Wake Union Church Rd Wake Forest NC 27587-9549 Ph: (919) 556-2997 |
NPI Number | 1285105270 |
---|---|
Provider Enumeration Date | 12/17/2018 |
Last Update Date | 11/16/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285105270 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |