NPI: 1730303389 · KENTWOOD, MI 49508 · General Practice Dentistry · NPI assigned 04/13/2007
| Authorized Official | ELLIS, JOSEPH (DENTIST) |
| NPI Enumeration Date | 04/13/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 12 | $210.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 12 | 12 | $210.00 |