SAULT DENTAL ASSOCIATION
NPI: 1114101318
· SAULT SAINTE MARIE, MI 49783
· General Practice Dentistry
· NPI assigned 12/24/2007
Provider Details
| Authorized Official | SHUNK, CLAYTON (GENERAL PARTNER) |
| NPI Enumeration Date | 12/24/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
153 |
$5K |
| 2019 |
170 |
$4K |
| 2020 |
43 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
314 |
307 |
$8K |
| D1110 |
Prophylaxis - adult |
40 |
40 |
$2K |
| D1120 |
Prophylaxis - child |
12 |
12 |
$480.00 |