1ST IMPRESSION DENTAL GROUP PLLC
NPI: 1558655910
· ARLINGTON, TX 76016
· General Practice Dentistry
· NPI assigned 06/02/2011
$176.40
Total Medicaid Paid
Provider Details
| Authorized Official | TRAN, VICTORIA (OWNER) |
| NPI Enumeration Date | 06/02/2011 |
Related Entities
Other providers sharing the same authorized official: TRAN, VICTORIA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
24 |
$176.40 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$176.40 |
| D0603 |
|
12 |
12 |
$0.00 |