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General NPI Number Information
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NPI Number | 1003143413
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Entity Type | Organization
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Legal Business Name | ALPINE SURGICAL ARTS, PC
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Dates
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Enumeration Date | 11/05/2009
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Last Update Date | 10/23/2020
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Provider Practice Location Address
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Address Line | 3300 N RUNNING CREEK WAY BUILDING H, SUITE 210
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City | LEHI
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State | UT
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Zip | 84043
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Country | US
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Telephone | 801-766-4834
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Fax | 801-766-2315
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Provider Business Mailing Address
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Address Line | 3300 N RUNNING CREEK WAY BUILDING H, SUITE 210
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City | LEHI
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State | UT
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Zip | 84043
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Country | US
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Telephone | 801-766-4834
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Fax | 801-766-2315
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Authorized Official
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Title or Position | OWNER
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Name | DR. TATE LOTT VIEHWEG
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Credential | DMD
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Telephone | 801-766-4834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 6632857
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License Number State | UT
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