NPI: 1083947162 · SHELBY TWP, MI 48315 · Dentist · NPI assigned 09/08/2009
| Authorized Official | VAN WALLEGHEM, PAUL (DENTIST-OWNER) |
| NPI Enumeration Date | 09/08/2009 |
Other providers sharing the same authorized official: VAN WALLEGHEM, PAUL
| Provider | City | State | Total Paid |
|---|---|---|---|
| POINTE FAMILY DENTISTRY | GROSSE POINTE FARMS | MI | $290.00 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 13 | $364.00 |
| 2023 | 25 | $690.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 38 | 37 | $1K |