NPI: 1689243537 · CHESTERFIELD, VA 23832 · Public Health Dentist · NPI assigned 06/23/2021
| Authorized Official | SHACKELFORD, TAMMY (EXECUTIVE DIRECTOR) |
| NPI Enumeration Date | 06/23/2021 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 26 | $736.20 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 26 | 26 | $736.20 |