NPI: 1033893045 · SAN MATEO, CA 94402 · Advanced Practice Dental Therapist · NPI assigned 06/12/2023
| Authorized Official | FONTAINE, COLETTE (REGISTERED DENTAL HYGIENIST AP) |
| NPI Enumeration Date | 06/12/2023 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 12 | $630.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | 12 | 12 | $630.00 |