NPI: 1770756496 · TUSCALOOSA, AL 35401 · Dental Clinic/Center · NPI assigned 04/03/2008
| Authorized Official | HYDRICK, G (PRESIDENT) |
| NPI Enumeration Date | 04/03/2008 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 13 | $202.80 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 13 | 13 | $202.80 |