NPI: 1912623141 · JACKSON, MS 39211 · Orthodontics and Dentofacial Orthopedic Dentist · NPI assigned 10/19/2022
| Authorized Official | EVANS, CLORA (OWNER) |
| NPI Enumeration Date | 10/19/2022 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 153 | $19K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D8670 | Periodic orthodontic treatment visit | 153 | 150 | $19K |