NPI: 1982803078 · LEE, MA 01238 · Dental Clinic/Center · NPI assigned 07/17/2007
| Authorized Official | DOMINOV, MICHAEL (PRESIDENT) |
| NPI Enumeration Date | 07/17/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 26 | $1K |
| 2019 | 14 | $637.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 40 | 38 | $2K |