NPI: 1669917308 · LIDGEWOOD, ND 58053 · General Practice Dentistry · NPI assigned 01/05/2017
| Authorized Official | SCHAFFER, MARK (OWER/DENTISH) |
| NPI Enumeration Date | 01/05/2017 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 16 | $330.48 |
| 2022 | 12 | $331.32 |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 28 | 27 | $661.80 |