NPI: 1740494137 · PORTVILLE, NY 14770 · General Practice Dentistry · NPI assigned 05/09/2007
| Authorized Official | MCDIVITT, OLIN (OWNER) |
| NPI Enumeration Date | 05/09/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 14 | $406.00 |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 14 | 14 | $406.00 |