NPI: 1073748042 · CLARKSVILLE, TN 37043 · Oral and Maxillofacial Surgery (Dentist) · NPI assigned 05/20/2009
| Authorized Official | LILLY, JASON (OWNER) |
| NPI Enumeration Date | 05/20/2009 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 13 | $380.25 |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 13 | 13 | $380.25 |