NPI: 1699438028 · SAINT CLAIR SHORES, MI 48080 · Dental Clinic/Center · NPI assigned 10/21/2021
| Authorized Official | JACOBS, DAVID (OWNER, DENTIST) |
| NPI Enumeration Date | 10/21/2021 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 12 | $348.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 12 | 12 | $348.00 |