TOOTHDAY AT W. MAIN AVE., PLLC
NPI: 1477295210
· ALTON, TX 78573
· General Practice Dentistry
· NPI assigned 04/12/2022
$420.31
Total Medicaid Paid
Provider Details
| Authorized Official | GARZA, SHARON (CREDENTIALING MANAGER) |
| NPI Enumeration Date | 04/12/2022 |
Related Entities
Other providers sharing the same authorized official: GARZA, SHARON
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2023 |
27 |
$420.31 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
12 |
$420.31 |
| D0603 |
|
14 |
13 |
$0.00 |