NPI: 1013422419 · RAPID CITY, SD 57702 · General Practice Dentistry · NPI assigned 12/06/2017
| Authorized Official | BURY, MATTHEW (PRESIDENT/ DENTIST) |
| NPI Enumeration Date | 12/06/2017 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 13 | $291.10 |
| 2024 | 12 | $415.50 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 25 | 25 | $706.60 |