DAVID A VAUGHAN DDS PA
NPI: 1407809403
· PORTLAND, ME 04103
· Dentist
· NPI assigned 05/18/2006
$504.00
Total Medicaid Paid
Provider Details
| Authorized Official | VAUGHAN, DAVID (PRESIDENT OWNER) |
| NPI Enumeration Date | 05/18/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
24 |
$504.00 |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$360.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$144.00 |