NPI: 1215101118 · CLINTON TWP, MI 48038 · General Practice Dentistry · NPI assigned 04/22/2008
| Authorized Official | GAYNOR, MARK (OWNER) |
| NPI Enumeration Date | 04/22/2008 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 14 | $392.00 |
| 2020 | 13 | $224.73 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 27 | 27 | $616.73 |