NPI: 1013044866 · WHITEFISH, MT 59937 · Dentist · NPI assigned 02/28/2007
| Authorized Official | BAX, DALE (OWNER) |
| NPI Enumeration Date | 02/28/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 13 | $420.75 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 13 | 12 | $420.75 |