NPI: 1255857728 · SAINT GEORGE, UT 84790 · Dental Clinic/Center · NPI assigned 08/16/2017
| Authorized Official | HENDRICKSON, NIELS (MANAGER) |
| NPI Enumeration Date | 08/16/2017 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 56 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 00170 | Anesthesia for intraoral procedures, including biopsy | 56 | 56 | $13K |