NPI: 1710361118 · PORT SULPHUR, LA 70083 · General Practice Dentistry · NPI assigned 07/15/2015
| Authorized Official | COOK, MIKE (OFFICE MANAGER) |
| NPI Enumeration Date | 07/15/2015 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 15 | $567.48 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 15 | 12 | $567.48 |