NPI: 1669079943 · PRATTVILLE, AL 36066 · General Practice Dentistry · NPI assigned 10/08/2020
| Authorized Official | HOLLEY, MATTHEW (PRESIDENT AND CEO) |
| NPI Enumeration Date | 10/08/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 13 | $260.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 13 | 13 | $260.00 |