NPI: 1194101055 · WAYZATA, MN 55391 · General Practice Dentistry · NPI assigned 08/03/2015
| Authorized Official | MARTINSON, BRUCE (DENTIST/ OWNER) |
| NPI Enumeration Date | 08/03/2015 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 12 | $375.88 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | 12 | 12 | $375.88 |