PRAIRIE GROVE DENTAL CENTER PLLC
NPI: 1508454612
· PRAIRIE GROVE, AR 72753
· General Practice Dentistry
· NPI assigned 01/05/2021
Provider Details
| Authorized Official | CLARK, ALAN (DENTIST-OWNER) |
| NPI Enumeration Date | 01/05/2021 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
66 |
$2K |
| 2023 |
153 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
59 |
59 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
91 |
91 |
$2K |
| D1206 |
Topical application of fluoride varnish |
45 |
45 |
$857.85 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$296.40 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$216.60 |