NPI: 1154052314 · CHEYENNE, WY 82009 · General Practice Dentistry · NPI assigned 06/20/2022
| Authorized Official | ESCOBEDO, BENJAMIN (DENTIST) |
| NPI Enumeration Date | 06/20/2022 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 16 | $468.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 16 | 15 | $468.00 |