C & O DENTAL ENTERPRISES PLC
NPI: 1558908145
· SANBORN, IA 51248
· Dental Clinic/Center
· NPI assigned 12/03/2019
$718.39
Total Medicaid Paid
Provider Details
| Authorized Official | CLAY, JOHN (OWNER) |
| Parent Organization | C & O DENTAL ENTERPRISES, PLC |
| NPI Enumeration Date | 12/03/2019 |
Related Entities
Other providers sharing the same authorized official: CLAY, JOHN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
80 |
$718.39 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
39 |
27 |
$360.14 |
| D1206 |
Topical application of fluoride varnish |
41 |
29 |
$358.25 |