BOLEN DENTAL PC
NPI: 1659962595
· CUSTER, SD 57730
· Dental Clinic/Center
· NPI assigned 02/02/2021
$478.27
Total Medicaid Paid
Provider Details
| Authorized Official | BOLEN, KARI (PRESIDENT BOLEN DENTAL PC) |
| NPI Enumeration Date | 02/02/2021 |
Related Entities
Other providers sharing the same authorized official: BOLEN, KARI
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
12 |
$478.27 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$478.27 |