NPI: 1326414426 · COMMERCE TOWNSHIP, MI 48382 · General Practice Dentistry · NPI assigned 08/12/2015
| Authorized Official | MANSOUR, ASHLEY (MANAGER) |
| NPI Enumeration Date | 08/12/2015 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 13 | $390.00 |
| 2024 | 15 | $369.53 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 28 | 28 | $759.53 |