SURFSIDE DENTAL LLC
NPI: 1316216500
· SURFSIDE BEACH, SC 29575
· General Practice Dentistry
· NPI assigned 12/19/2011
Provider Details
| Authorized Official | WILLIS, SCOTT (MEMBER) |
| NPI Enumeration Date | 12/19/2011 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
68 |
$2K |
| 2019 |
50 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
105 |
105 |
$2K |
| D1110 |
Prophylaxis - adult |
13 |
13 |
$655.20 |