GRAND LEDGE FAMILY DENTISTRY, PLLC
NPI: 1972199156
· GRAND LEDGE, MI 48837
· Dentist
· NPI assigned 12/11/2020
Provider Details
| Authorized Official | MULDER, KYLE (OWNER) |
| NPI Enumeration Date | 12/11/2020 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
26 |
$371.23 |
| 2022 |
54 |
$916.00 |
| 2023 |
26 |
$495.14 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
80 |
80 |
$1K |
| D1120 |
Prophylaxis - child |
12 |
12 |
$252.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
14 |
$200.00 |