Healthcare Provider Details

I. General information

NPI: 1881935906
Provider Name (Legal Business Name): ALPINE CONSUMER MARKETING & SOFTWARE CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2013
Last Update Date: 07/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

686 E 110 S UNIT 201
AMERICAN FORK UT
84003-2871
US

IV. Provider business mailing address

686 E 110 S UNIT 201
AMERICAN FORK UT
84003-2871
US

V. Phone/Fax

Practice location:
  • Phone: 801-692-0147
  • Fax: 801-756-7780
Mailing address:
  • Phone: 801-692-0147
  • Fax: 801-756-7780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number313143-9923
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. ARNOUD NOOT
Title or Position: CO-OWNER
Credential: D.D.S.
Phone: 801-692-0147