NPI: 1487390662 · TRENT WOODS, NC 28562 · General Practice Dentistry · NPI assigned 05/10/2022
| Authorized Official | RUSSELL, MARK (MEMBER AND MANAGER) |
| NPI Enumeration Date | 05/10/2022 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 19 | $288.56 |
| 2024 | 12 | $280.56 |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 31 | 24 | $569.12 |