NPI: 1669912952 · JACKSON, NJ 08527 · General Practice Dentistry · NPI assigned 03/06/2017
| Authorized Official | KUNDURU, MADHAVI (OFFICE MANAGER) |
| NPI Enumeration Date | 03/06/2017 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 13 | $569.25 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 13 | 13 | $569.25 |