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
—
—
1223X2210X
Orofacial Pain Dentistry
—
—
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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