NPI: 1891986378 · MINNETONKA, MN 55345 · General Practice Dentistry · NPI assigned 08/08/2007
| Authorized Official | PARK, IAN (OWNER) |
| NPI Enumeration Date | 08/08/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 13 | $451.38 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 13 | 13 | $451.38 |