GLYNWOOD PARK DENTAL CARE
NPI: 1164796959
· PRATTVILLE, AL 36066
· General Practice Dentistry
· NPI assigned 02/27/2012
$384.00
Total Medicaid Paid
Provider Details
| Authorized Official | STEWART, SUSAN (OFFICE MANAGER) |
| NPI Enumeration Date | 02/27/2012 |
Related Entities
Other providers sharing the same authorized official: STEWART, SUSAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
12 |
$384.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$384.00 |