NPI: 1235583832 · ROSEMOUNT, MN 55068 · General Practice Dentistry · NPI assigned 04/20/2016
| Authorized Official | HO, LE (PRESIDENT) |
| NPI Enumeration Date | 04/20/2016 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 25 | $820.71 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 25 | 25 | $820.71 |