NPI: 1104932425 · ROCKFORD, MI 49341 · Dentist · NPI assigned 08/21/2006
| Authorized Official | DATER, STEVEN (OWNER) |
| NPI Enumeration Date | 08/21/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 13 | $112.00 |
| 2021 | 14 | $280.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 27 | 27 | $392.00 |