GRUPO DENTAL DR. JOSE S BELAVAL
NPI: 1053681999
· SAN JUAN, PR 00915
· Dental Clinic/Center
· NPI assigned 01/10/2012
$287.00
Total Medicaid Paid
Provider Details
| Authorized Official | VEGA DE JESUS, MARITZA (EXECUTIVE SUB DIRECTOR) |
| Parent Organization | CDT DR. JOSE S BELAVAL |
| NPI Enumeration Date | 01/10/2012 |
Related Entities
Other providers sharing the same authorized official: VEGA DE JESUS, MARITZA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
13 |
$287.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
13 |
13 |
$287.00 |