NPI: 1043908155 · SUMMERVILLE, SC 29483 · Oral and Maxillofacial Surgery (Dentist) · NPI assigned 04/26/2023
| Authorized Official | BAZZLE, ANGIE (OPERATIONS MANAGER) |
| NPI Enumeration Date | 04/26/2023 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 15 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D9310 | 15 | 15 | $1K |