NPI: 1962131920 · ROYAL OAK, MI 48067 · General Practice Dentistry · NPI assigned 06/06/2022
| Authorized Official | ANSARI, SOHRAB (PRESIDENT/DENTIST) |
| NPI Enumeration Date | 06/06/2022 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 14 | $612.56 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 14 | 14 | $612.56 |