NPI: 1336749522 · PLYMOUTH, MI 48170 · General Practice Dentistry · NPI assigned 10/28/2020
| Authorized Official | SADOWSKI, DONNA (OFFICE MGR) |
| NPI Enumeration Date | 10/28/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 12 | $145.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 12 | 12 | $145.00 |