NPI: 1740731470 · BANGOR, ME 04401 · General Practice Dentistry · NPI assigned 10/18/2016
| Authorized Official | HALUSKA, DAVID (PRESIDENT) |
| NPI Enumeration Date | 10/18/2016 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 13 | $360.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 13 | 13 | $360.00 |