KENMARE DENTAL CLINIC
NPI: 1164677399
· KENMARE, ND 58746
· General Practice Dentistry
· NPI assigned 12/02/2008
$658.50
Total Medicaid Paid
Provider Details
| Authorized Official | THELEN, TRACY (OFFICE MANAGER) |
| Parent Organization | KENMARE DENTAL CLINIC |
| NPI Enumeration Date | 12/02/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
16 |
$342.42 |
| 2020 |
29 |
$316.08 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
29 |
28 |
$658.50 |
| D1999 |
|
16 |
15 |
$0.00 |