NPI: 1023180528 · CHARLESTON, SC 29412 · Dental Clinic/Center · NPI assigned 11/14/2006
| Authorized Official | WILSON, TERESA (OFFICE MANAGER) |
| NPI Enumeration Date | 11/14/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 52 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 52 | 52 | $1K |