DENT-AL SMILES, LLC
NPI: 1720510001
· FAIRFIELD, OH 45014
· Dental Clinic/Center
· NPI assigned 03/28/2017
$773.02
Total Medicaid Paid
Provider Details
| Authorized Official | LAZO, ALVARO (OWNER) |
| NPI Enumeration Date | 03/28/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
29 |
$773.02 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0330 |
Panoramic radiographic image |
17 |
16 |
$509.52 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$263.50 |