NPI: 1780290676 · DEERFIELD, IL 60015 · Dental Clinic/Center · NPI assigned 09/16/2020
| Authorized Official | MORALES, JACQUELINE (DISTRICT MANAGER) |
| Parent Organization | GREAT SMILE DENTAL PLLC |
| NPI Enumeration Date | 09/16/2020 |
Other providers sharing the same authorized official: MORALES, JACQUELINE
| Provider | City | State | Total Paid |
|---|---|---|---|
| CROWN OF LIFE NY LLC | BROOKLYN | NY | $67.67M |
| GREAT SMILE DENTAL PLLC | LAS VEGAS | NV | $274K |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 91 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D8660 | 91 | 82 | $4K |