NPI: 1710093281 · WALHALLA, SC 29691 · General Practice Dentistry · NPI assigned 08/21/2006
| Authorized Official | BRYSON, SIDNEY (PRESIDENT) |
| NPI Enumeration Date | 08/21/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $207.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 12 | 12 | $207.00 |