AFFORDABLE SMILES INC.
NPI: 1629491568
· CORRY, PA 16407
· Dentist
· NPI assigned 01/29/2014
$778.00
Total Medicaid Paid
Provider Details
| Authorized Official | EVALT, LEVI (PRESIDENT) |
| NPI Enumeration Date | 01/29/2014 |
Related Entities
Other providers sharing the same authorized official: EVALT, LEVI
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
27 |
$778.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0330 |
Panoramic radiographic image |
14 |
14 |
$518.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$260.00 |