NPI: 1609316454 · NORTH CHARLESTON, SC 29418 · General Practice Dentistry · NPI assigned 02/27/2017
| Authorized Official | CONDREY, COLLEEN (OFFICE MANAGER) |
| NPI Enumeration Date | 02/27/2017 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 13 | $299.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 13 | 13 | $299.00 |