NPI: 1437223120 · LOWDEN, IA 52255 · General Practice Dentistry · NPI assigned 11/17/2006
| Authorized Official | SAMUELSON, DAVID (OWNER) |
| NPI Enumeration Date | 11/17/2006 |
Other providers sharing the same authorized official: SAMUELSON, DAVID
| Provider | City | State | Total Paid |
|---|---|---|---|
| JERSEY RIDGE DENTAL ASSOCIATES | DAVENPORT | IA | $23K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 41 | $478.87 |
| 2021 | 12 | $175.82 |
| 2022 | 13 | $216.12 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 66 | 62 | $870.81 |