31 ELMGROVE DENTAL LLC
NPI: 1225787708
· PROVIDENCE, RI 02906
· General Practice Dentistry
· NPI assigned 03/22/2022
Provider Details
| Authorized Official | POLAK, JESSICA (OFFICE MANAGER) |
| NPI Enumeration Date | 03/22/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
40 |
$800.00 |
| 2023 |
24 |
$888.00 |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
39 |
37 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
25 |
24 |
$362.00 |