NPI: 1154446672 · PORTLAND, ME 04103 · General Practice Dentistry · NPI assigned 03/21/2007
| Authorized Official | PEACOCK CATHCART, ALEXANDRA (OWNER) |
| NPI Enumeration Date | 03/21/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 12 | $120.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 12 | 12 | $120.00 |