MONTANA DENTAL SPA
NPI: 1952947319
· KALISPELL, MT 59901
· Dental Clinic/Center
· NPI assigned 11/20/2019
Provider Details
| Authorized Official | SEAMAN, GREGORY (DOCTOR) |
| Parent Organization | GREGORY SEAMAN |
| NPI Enumeration Date | 11/20/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
57 |
$2K |
| 2022 |
319 |
$13K |
| 2023 |
472 |
$16K |
| 2024 |
335 |
$11K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
471 |
434 |
$23K |
| D0120 |
Periodic oral evaluation - established patient |
408 |
377 |
$10K |
| D1206 |
Topical application of fluoride varnish |
245 |
223 |
$5K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
20 |
12 |
$3K |
| D0274 |
Bitewings - four radiographic images |
39 |
37 |
$1K |