| Alpine Family Dental Llc | |
|
875 Roosevelt Hwy Suite 110 Colchester VT 05446-4460 | |
| (802) 862-5052 | |
| (802) 660-3991 |
| Full Name | Alpine Family Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 875 Roosevelt Hwy, Colchester, Vermont |
| Authorized Official Name and Position | Stephen Monroe Pitmon (OWNER) |
| Authorized Official Contact | 8028625052 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpine Family Dental Llc 875 Roosevelt Hwy Suite 110 Colchester VT 05446-4460 Ph: (802) 862-5052 | Alpine Family Dental Llc 875 Roosevelt Hwy Suite 110 Colchester VT 05446-4460 Ph: (802) 862-5052 |
| NPI Number | 1679786842 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 01/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679786842 | NPI | - | NPPES |
| 1003378 | Medicaid | VT | |
| 1437153798 | Other | TYPE 1 NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 016-0001072 (Vermont) | Primary |
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