NPI: 1346569100 · WATERFORD, MI 48329 · General Practice Dentistry · NPI assigned 05/19/2010
| Authorized Official | WALSH, ANGELA (OFFICE MANAGER) |
| NPI Enumeration Date | 05/19/2010 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 16 | $392.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 16 | 16 | $392.00 |