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Organization
ALPINE DT FORT COLLINS LLC
Active
Organization
ALPINE DT FORT COLLINS LLC
Active
Other names
Alpine Dental Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MESA ROTH DDS (PARTNER)
(970) 484-5297
Entity
Organization
Contact information
Practice address
950 S TAFT HILL RD, FORT COLLINS, CO 80521-3230
(970) 484-5297
Mailing address
950 S TAFT HILL RD, FORT COLLINS, CO 80521-3230
(970) 484-5297
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
1223X2210X
Orofacial Pain Dentistry
—
NULL
1223X2210X
Orofacial Pain Dentistry
—
—
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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