WEST RANGE DENTAL PLLC
NPI: 1437978004
· GRAND RAPIDS, MN 55744
· Dental Clinic/Center
· NPI assigned 10/09/2024
$763.47
Total Medicaid Paid
Provider Details
| Authorized Official | HAMMER, KYLE (OWNER PRESIDENT) |
| Parent Organization | KYLE HAMMER DDS PLLC |
| NPI Enumeration Date | 10/09/2024 |
Related Entities
Other providers sharing the same authorized official: HAMMER, KYLE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
17 |
$763.47 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
17 |
17 |
$763.47 |