NPI: 1366156820 · BETTENDORF, IA 52722 · Pediatric Dentist · NPI assigned 01/10/2023
| Authorized Official | CROCK, SANDY (CONTROLLER) |
| NPI Enumeration Date | 01/10/2023 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 16 | $243.18 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 16 | 16 | $243.18 |