NPI: 1063154060 · MONROE, MI 48161 · Dental Clinic/Center · NPI assigned 04/11/2022
| Authorized Official | MANCZAK, NEIL (OWNER) |
| NPI Enumeration Date | 04/11/2022 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 12 | $360.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 12 | 12 | $360.00 |