NPI: 1134505746 · ESSEXVILLE, MI 48732 · General Practice Dentistry · NPI assigned 08/05/2015
| Authorized Official | MALLAIS, TERRA (OWNER/DENTIST) |
| NPI Enumeration Date | 08/05/2015 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 13 | $137.70 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 13 | 13 | $137.70 |