NPI: 1326132226 · WYANDOTTE, MI 48192 · General Practice Dentistry · NPI assigned 10/03/2006
| Authorized Official | ANDRES, TIMOTHY (PRESIDENT) |
| NPI Enumeration Date | 10/03/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 12 | $242.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 12 | 12 | $242.00 |