LARSEN FAMILY DENTISTRY, P.C.
NPI: 1205010287
· JACKSON, WY 83001
· General Practice Dentistry
· NPI assigned 12/26/2007
Provider Details
| Authorized Official | LARSEN, SCOTT (DENTIST) |
| NPI Enumeration Date | 12/26/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
72 |
$1K |
| 2019 |
26 |
$527.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
27 |
27 |
$832.00 |
| D1206 |
Topical application of fluoride varnish |
58 |
58 |
$550.00 |
| D1110 |
Prophylaxis - adult |
13 |
13 |
$500.00 |