NPI: 1679178206 · POWDERSVILLE, SC 29673 · Dental Clinic/Center · NPI assigned 12/01/2020
| Authorized Official | SHIGLEY, BRETT (PRESIDENT) |
| NPI Enumeration Date | 12/01/2020 |
Other providers sharing the same authorized official: SHIGLEY, BRETT
| Provider | City | State | Total Paid |
|---|---|---|---|
| PALMETTO OFS, LLC | GREENVILLE | SC | $2K |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 13 | $455.20 |
| 2023 | 24 | $851.20 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0140 | Limited oral evaluation - problem focused | 37 | 37 | $1K |