NPI: 1093266215 · DETROIT, MI 48223 · Dentist · NPI assigned 10/24/2016
| Authorized Official | STEWART, LAWRENCE (DOC/PARTNER) |
| NPI Enumeration Date | 10/24/2016 |
Other providers sharing the same authorized official: STEWART, LAWRENCE
| Provider | City | State | Total Paid |
|---|---|---|---|
| SOUTHWEST MISSISSIPPI EAR, NOSE & THROAT CLINIC, P.A. | MCCOMB | MS | $528K |
| FILL GOOD DENTAL CARE INC | DETROIT | MI | $6K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $480.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 12 | 12 | $480.00 |