NPI: 1639204852 · PORTAGE, MI 49024 · Dentist · NPI assigned 02/21/2007
| Authorized Official | NICOLA, ROBERT (OWNER) |
| NPI Enumeration Date | 02/21/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 13 | $573.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 13 | 12 | $573.00 |