NPI: 1447990445 · LEAGUE CITY, TX 77573 · General Practice Dentistry · NPI assigned 03/30/2022
| Authorized Official | PRANATA, FELICIA (MANAGER) |
| NPI Enumeration Date | 03/30/2022 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 12 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0603 | 12 | 12 | $0.00 |