Provider Demographics
NPI:1427352996
Name:ALICE KANIFF DDS PC
Entity type:Organization
Organization Name:ALICE KANIFF DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KANIFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-319-2999
Mailing Address - Street 1:PO BOX 3251
Mailing Address - Street 2:
Mailing Address - City:BASALT
Mailing Address - State:CO
Mailing Address - Zip Code:81621-3251
Mailing Address - Country:US
Mailing Address - Phone:970-319-2999
Mailing Address - Fax:970-927-3467
Practice Address - Street 1:310 MARKET ST
Practice Address - Street 2:
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621-7401
Practice Address - Country:US
Practice Address - Phone:970-319-2999
Practice Address - Fax:970-927-3467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN 89671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty