NPI: 1346873288 · ROSEVILLE, MI 48066 · Dental Clinic/Center · NPI assigned 02/19/2020
| Authorized Official | VAN DE VYVER, SHAWN (DENTIST) |
| NPI Enumeration Date | 02/19/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 12 | $308.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | 12 | 12 | $308.00 |