NPI: 1528568789 · SMITHS GROVE, KY 42171 · General Practice Dentistry · NPI assigned 02/14/2018
| Authorized Official | WALDEN, GARY (OWNER) |
| NPI Enumeration Date | 02/14/2018 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 12 | $661.43 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 12 | 12 | $661.43 |