NPI: 1750616694 · HERNDON, VA 20170 · General Practice Dentistry · NPI assigned 10/09/2009
| Authorized Official | TAJALLI, FLORA (OWNER) |
| NPI Enumeration Date | 10/09/2009 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $249.48 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1208 | Topical application of fluoride, excluding varnish | 12 | 12 | $249.48 |