All Medicaid billing entities listing BOUSTANY, AMANDA (OWNER) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| West Virginia | 1 | $969.00 |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | CAPITOL ENDODONTICS, PLLC | CHARLESTON, WV | Endodontist | $969.00 |