# ALPINE DT FORT COLLINS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Alpine Dental Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326775800
- **Authorized official:** DR. MESA ROTH DDS (PARTNER)
- **Authorized official phone:** (970) 484-5297

## Contact information

- **Practice address:** 950 S TAFT HILL RD, FORT COLLINS, CO 80521-3230
- **Practice address phone:** (970) 484-5297
- **Mailing address:** 950 S TAFT HILL RD, FORT COLLINS, CO 80521-3230
- **Mailing address phone:** (970) 484-5297

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 1223X2210X | Orofacial Pain Dentistry | — | NULL | — |
| 1223X2210X | Orofacial Pain Dentistry | — | — | — |

## Other

- **Enumeration date:** 08/04/2022
- **Last updated:** 08/04/2022