| Organization Name: | RICCOBENE & ASSOCIATES XIV, DDS, P.A. |
| NPI Number: | 1164894937 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NICOLE JOHNSON (EXECUTIVE COORDINATOR) |
| Mailing Address: | 5638 Nc Highway 42 W Ste 109 Suite 109 Garner |
| State: | NC US |
| Postal Code: | 275297998 |
| Phone Number: | 9196616161 |
| Fax Number: | |
| NPI Enumeration Date: | 10/20/2015 |
| NPI Last Update Date: | 10/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |