JUST FOR KIDS DENTAL ENNIS
NPI: 1629344239
· ENNIS, TX 75119
· Pediatric Dentist
· NPI assigned 03/28/2012
$205.80
Total Medicaid Paid
Provider Details
| Authorized Official | HERRON, MARTHA (INSURANCE COORDINATOR) |
| NPI Enumeration Date | 03/28/2012 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
27 |
$205.80 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
14 |
$205.80 |
| D0603 |
|
13 |
13 |
$0.00 |