GREAT LAKES FAMILY DENTAL GROUP - GRAND BLANC
NPI: 1720323173
· GRAND BLANC, MI 48439
· General Practice Dentistry
· NPI assigned 12/11/2012
Provider Details
| Authorized Official | GRAY, CLARENCE (OWNER/PRESIDENT) |
| NPI Enumeration Date | 12/11/2012 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
26 |
$576.00 |
| 2019 |
66 |
$2K |
| 2020 |
27 |
$580.00 |
| 2021 |
66 |
$1K |
| 2022 |
156 |
$4K |
| 2023 |
13 |
$390.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
159 |
159 |
$4K |
| D1208 |
Topical application of fluoride, excluding varnish |
119 |
119 |
$2K |
| D1120 |
Prophylaxis - child |
64 |
64 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$204.00 |