NPI: 1285824565 · DALTON, GA 30720 · Dentist · NPI assigned 08/01/2007
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 49 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 13 | 13 | $348.66 |
| D0150 | Comprehensive oral evaluation - new or established patient | 12 | 12 | $307.68 |
| D0120 | Periodic oral evaluation - established patient | 12 | 12 | $178.11 |
| D1208 | Topical application of fluoride, excluding varnish | 12 | 12 | $176.52 |