NPI: 1326654385 · KINGSFORD, MI 49802 · General Practice Dentistry · NPI assigned 09/16/2020
| Authorized Official | HOLLEN, JENNIFER (CLINICAL MANAGER) |
| NPI Enumeration Date | 09/16/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 13 | $175.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 13 | 13 | $175.00 |