NPI: 1972267284 · RAYTOWN, MO 64133 · Dental Clinic/Center · NPI assigned 10/25/2021
| Authorized Official | JOHNSON, DWIGHT (DENTIST) |
| NPI Enumeration Date | 10/25/2021 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 12 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0210 | Intraoral - complete series of radiographic images | 12 | 12 | $1K |