SMILE LOFT MIDDLE RIVER LLC
NPI: 1912749417
· MIDDLE RIVER, MD 21220
· Dental Clinic/Center
· NPI assigned 06/07/2024
$597.35
Total Medicaid Paid
Provider Details
| Authorized Official | RAI, VAIBHAV (OWNER/MEMBER) |
| NPI Enumeration Date | 06/07/2024 |
Related Entities
Other providers sharing the same authorized official: RAI, VAIBHAV
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
13 |
$597.35 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0330 |
Panoramic radiographic image |
13 |
13 |
$597.35 |