NPI: 1104402544 · PHILADELPHIA, MS 39350 · Dental Clinic/Center · NPI assigned 03/23/2021
| Authorized Official | HORN, THOMAS (GENERAL DENTIST) |
| NPI Enumeration Date | 03/23/2021 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 12 | $411.68 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 12 | 12 | $411.68 |