NPI: 1629315932 · RAPID CITY, SD 57702 · Dentist · NPI assigned 01/07/2013
| Authorized Official | TAYLOR, JARED (OWNER) |
| NPI Enumeration Date | 01/07/2013 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 13 | $369.72 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 13 | 13 | $369.72 |