SMITH DENTISTRY PLLC
NPI: 1043065030
· KALKASKA, MI 49646
· General Practice Dentistry
· NPI assigned 04/22/2024
$760.00
Total Medicaid Paid
Provider Details
| Authorized Official | SMITH, GRANT (PRESIDENT/OWNER) |
| NPI Enumeration Date | 04/22/2024 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
28 |
$760.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
15 |
15 |
$435.00 |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$325.00 |