NPI: 1316097116 · EDEN PRAIRIE, MN 55347 · Orthodontics and Dentofacial Orthopedic Dentist · NPI assigned 01/12/2007
| Authorized Official | ALICK, DIANE (DDS, MS) |
| NPI Enumeration Date | 01/12/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 70 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D8080 | Comprehensive orthodontic treatment of the adolescent dentition | 70 | 65 | $5K |