NPI: 1861102840 · FAIRBURY, NE 68352 · Dental Clinic/Center · NPI assigned 11/30/2022
| Authorized Official | GRANT, JASON (OWNER) |
| NPI Enumeration Date | 11/30/2022 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 13 | $291.06 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 13 | 12 | $291.06 |