NPI: 1033294129 · BRIDGEPORT, WV 26330 · General Practice Dentistry · NPI assigned 10/26/2006
| Authorized Official | OGDEN, GEROLD (OWNER) |
| NPI Enumeration Date | 10/26/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 12 | $327.60 |
| 2020 | 12 | $261.20 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1208 | Topical application of fluoride, excluding varnish | 24 | 24 | $588.80 |