NPI: 1558761031 · EAST HARTFORD, CT 06108 · Pediatric Dentist · NPI assigned 09/03/2014
| Authorized Official | KWON, YOON JOONG (MEMBER) |
| NPI Enumeration Date | 09/03/2014 |
Other providers sharing the same authorized official: KWON, YOON JOONG
| Provider | City | State | Total Paid |
|---|---|---|---|
| CONNECTIDENT, LLC | EAST HARTFORD | CT | $3.68M |
| MAGICLAND DENTAL LLC | HARTFORD | CT | $171K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 13 | $397.60 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 13 | 13 | $397.60 |