Healthcare Provider Details

I. General information

NPI: 1497541437
Provider Name (Legal Business Name): ALPINE DENTAL ANESTHESIA ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10284 ROWLOCK WAY
PARKER CO
80134-9577
US

IV. Provider business mailing address

10284 ROWLOCK WAY
PARKER CO
80134-9577
US

V. Phone/Fax

Practice location:
  • Phone: 801-310-8244
  • Fax:
Mailing address:
  • Phone: 801-310-8244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAUREAN TRAVAS SMITH
Title or Position: MANAGER/CEO
Credential: DMD
Phone: 801-310-8244