RELIANT DENTAL GROUP PC
NPI: 1104399443
· WEST ROXBURY, MA 02132
· General Practice Dentistry
· NPI assigned 01/09/2019
$724.00
Total Medicaid Paid
Provider Details
| Authorized Official | SOARES, THIAGO (ADMINISTRATOR) |
| Parent Organization | RELIANT DENTAL GROUP LLC |
| NPI Enumeration Date | 01/09/2019 |
Related Entities
Other providers sharing the same authorized official: SOARES, THIAGO
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
14 |
$724.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
14 |
14 |
$724.00 |