Provider Demographics
NPI:1528525441
Name:ALPINE DENTAL CARE, LLC
Entity type:Organization
Organization Name:ALPINE DENTAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:L
Authorized Official - Last Name:LINFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:307-654-2273
Mailing Address - Street 1:P.O. BOX 3469
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:WY
Mailing Address - Zip Code:83128
Mailing Address - Country:US
Mailing Address - Phone:307-654-2273
Mailing Address - Fax:307-654-2275
Practice Address - Street 1:363 DEER LANE
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:WY
Practice Address - Zip Code:83128
Practice Address - Country:US
Practice Address - Phone:307-654-2273
Practice Address - Fax:307-654-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty