NPI: 1467684399 · TRENTON, MI 48183 · General Practice Dentistry · NPI assigned 08/11/2009
| Authorized Official | PUSKARICH, KELLY (BUSINESS ASST.) |
| Parent Organization | 2901010486 |
| NPI Enumeration Date | 08/11/2009 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $492.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 12 | 12 | $492.00 |