NPI: 1033723309 · FERGUS FALLS, MN 56537 · Dental Clinic/Center · NPI assigned 09/03/2020
| Authorized Official | KLOVSTAD, CHARLENE (BUSINESS MANAGER) |
| NPI Enumeration Date | 09/03/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 15 | $292.31 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 15 | 15 | $292.31 |