NPI: 1558655761 · GLENPOOL, OK 74033 · General Practice Dentistry · NPI assigned 06/06/2011
| Authorized Official | NOAH, RYAN (OWNER/DOCTOR) |
| NPI Enumeration Date | 06/06/2011 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 15 | $296.10 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 15 | 15 | $296.10 |