NPI: 1992484844 · BOULDER, CO 80301 · Dental Clinic/Center · NPI assigned 07/17/2023
| Authorized Official | ALTDORFER, JEREMY (CEO EXTRORDINAIRE) |
| NPI Enumeration Date | 07/17/2023 |
Other providers sharing the same authorized official: ALTDORFER, JEREMY
| Provider | City | State | Total Paid |
|---|---|---|---|
| EXPERIENCE DENTAL 2 PLLC | THORNTON | CO | $403K |
| EXPERIENCE DENTAL PLLC | BOULDER | CO | $263K |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 38 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 38 | 37 | $2K |