NPI: 1356492185 · WALLINGFORD, CT 06492 · General Practice Dentistry · NPI assigned 01/16/2007
| Authorized Official | SCHUPACK, ALAN (MANAGER) |
| NPI Enumeration Date | 01/16/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 14 | $264.60 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 14 | 12 | $264.60 |