NPI: 1801045828 · LATHRUP VILLAGE, MI 48076 · General Practice Dentistry · NPI assigned 09/15/2008
| Authorized Official | WARD, WENDI (ACCOUNTS MANAGER) |
| NPI Enumeration Date | 09/15/2008 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 15 | $350.24 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | 15 | 15 | $350.24 |