NPI: 1992870570 · BOONVILLE, NY 13309 · Dentist · NPI assigned 11/21/2006
| Authorized Official | CARUSO, THOMAS (DENTIST VICE PRES) |
| NPI Enumeration Date | 11/21/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 14 | $381.64 |
| 2022 | 12 | $327.12 |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 26 | 26 | $708.76 |