NPI: 1003250416 · CASTLE ROCK, CO 80109 · General Practice Dentistry · NPI assigned 04/29/2013
| Authorized Official | EHTESSABIAN, JASON (OWNER/DENTIST) |
| NPI Enumeration Date | 04/29/2013 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 14 | $248.57 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 14 | 14 | $248.57 |