PLEASANT GROVE FAMILY DENTISTRY
NPI: 1316490832
· TEXARKANA, TX 75503
· General Practice Dentistry
· NPI assigned 08/02/2016
$994.70
Total Medicaid Paid
Provider Details
| Authorized Official | MARRACINO, TORIN (DENTIST/OWNER) |
| Parent Organization | TORIN MARRACINO DDS, INC |
| NPI Enumeration Date | 08/02/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
24 |
$176.40 |
| 2021 |
134 |
$818.30 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
38 |
38 |
$543.90 |
| D0240 |
|
48 |
24 |
$450.80 |
| D0602 |
|
72 |
66 |
$0.00 |