NPI: 1942474374 · MANCHESTER, NH 03103 · General Practice Dentistry · NPI assigned 04/16/2008
| Authorized Official | LAMONTAGNE, ROGER (OWNER/DENTIST) |
| NPI Enumeration Date | 04/16/2008 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 220 | $6K |
| 2019 | 76 | $2K |
| 2020 | 26 | $817.70 |
| 2021 | 26 | $651.14 |
| 2022 | 112 | $3K |
| 2023 | 105 | $3K |
| 2024 | 108 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 352 | 338 | $10K |
| D1120 | Prophylaxis - child | 68 | 68 | $2K |
| D1206 | Topical application of fluoride varnish | 123 | 115 | $2K |
| D1110 | Prophylaxis - adult | 31 | 31 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 71 | 71 | $1K |
| D1330 | 28 | 24 | $0.00 |