DENTAL SERVICES ORGANIZATION LLC

Case Management

Code: 251B00000X

Clinic/Center — Critical Access Hospital

Code: 261QC0050X

Clinic/Center — Dental

Code: 261QD0000X

Clinic/Center — Emergency Care

Code: 261QE0002X

Clinic/Center — Health Service

Code: 261QH0100X

Clinic/Center — Adolescent and Children Mental Health

Code: 261QM0855X

Clinic/Center — Multi-Specialty

Code: 261QM1300X

Clinic/Center — Primary Care

Code: 261QP2300X

Clinic/Center — Radiology

Code: 261QR0200X

Clinic/Center — Radiology, Mammography

Code: 261QR0206X

Clinic/Center — Urgent Care

Code: 261QU0200X

Clinical Medical Laboratory

Code: 291U00000X

Exclusive Provider Organization

Code: 302F00000X

Pharmacy — Clinic Pharmacy

Code: 3336C0002X

Clinic/Center

Code: 261Q00000X