NPI: 1467924290 · EXCELSIOR, MN 55331 · Pediatric Dentist · NPI assigned 12/18/2018
| Authorized Official | AUGUSTYN, BOBBI (OWNER) |
| NPI Enumeration Date | 12/18/2018 |
Other providers sharing the same authorized official: AUGUSTYN, BOBBI
| Provider | City | State | Total Paid |
|---|---|---|---|
| CAMP SMILE PEDIATRIC DENTISTRY CHASKA | CHASKA | MN | $2K |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 12 | $259.08 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 12 | 12 | $259.08 |