NPI: 1871611152 · JENISON, MI 49428 · General Practice Dentistry · NPI assigned 03/26/2007
| Authorized Official | AYLWORTH, HOLLY (DENTIST) |
| NPI Enumeration Date | 03/26/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $284.38 |
| 2019 | 12 | $196.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 24 | 24 | $480.38 |