NPI: 1447660261 · BOTTINEAU, ND 58318 · Case Management Agency · NPI assigned 05/01/2014
| Authorized Official | JENSEN, KELLY (DIRECTOR II) |
| NPI Enumeration Date | 05/01/2014 |
Other providers sharing the same authorized official: JENSEN, KELLY
| Provider | City | State | Total Paid |
|---|---|---|---|
| KALISPELL DENTURE STUDIO, LLC | KALISPELL | MT | $65K |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 26 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 00015 | 26 | 25 | $3K |