ACADEMY DENTAL PA
NPI: 1316955396
· PRESQUE ISLE, ME 04769
· General Practice Dentistry
· NPI assigned 08/04/2006
Provider Details
| Authorized Official | BOUCHARD, SANDI (OFFICE/BUSINESS MANAGER) |
| NPI Enumeration Date | 08/04/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
59 |
$912.00 |
| 2019 |
59 |
$624.00 |
| 2020 |
15 |
$144.00 |
| 2022 |
18 |
$319.28 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
139 |
127 |
$2K |
| D1120 |
Prophylaxis - child |
12 |
12 |
$360.00 |