NPI: 1003574336 · BEAVERTON, OR 97006 · Dentist · NPI assigned 12/03/2021
| Authorized Official | SY, MOUSTAPHA (OWNER/DENTIST) |
| NPI Enumeration Date | 12/03/2021 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 19 | $684.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 19 | 12 | $684.00 |