NPI: 1902943657 · MINNETONKA, MN 55305 · General Practice Dentistry · NPI assigned 01/31/2007
| Authorized Official | WAGNILD, WILLIAM (OWNER PRESIDENT) |
| NPI Enumeration Date | 01/31/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 16 | $584.18 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 16 | 16 | $584.18 |