WATERFORD FAMILY DENTAL PLLC
NPI: 1306454723
· WATERFORD, MI 48329
· Dental Clinic/Center
· NPI assigned 07/22/2020
$792.00
Total Medicaid Paid
Provider Details
| Authorized Official | DRUMMOND, MEGAN (MANAGEMENT) |
| NPI Enumeration Date | 07/22/2020 |
Related Entities
Other providers sharing the same authorized official: DRUMMOND, MEGAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
24 |
$792.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
12 |
12 |
$492.00 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$300.00 |