NPI: 1033574827 · CHEYENNE, WY 82009 · General Practice Dentistry · NPI assigned 12/21/2015
| Authorized Official | KINCHELOE, BRADLEY (DENTIST) |
| NPI Enumeration Date | 12/21/2015 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 12 | $384.00 |
| 2024 | 12 | $468.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 24 | 24 | $852.00 |