NPI: 1043430598 · GRANDVILLE, MI 49418 · Dentist · NPI assigned 04/26/2007
| Authorized Official | DRAFT, DEREK (VP TREAS) |
| NPI Enumeration Date | 04/26/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 13 | $333.89 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 13 | 13 | $333.89 |