CLARK ORAL & FACIAL SURGERY
NPI: 1649040858
· TWIN FALLS, ID 83301
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 01/08/2024
$116.76
Total Medicaid Paid
Provider Details
| Authorized Official | CLARK, PAUL (SURGEON, OWNER) |
| NPI Enumeration Date | 01/08/2024 |
Related Entities
Other providers sharing the same authorized official: CLARK, PAUL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
28 |
$116.76 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
28 |
28 |
$116.76 |