Healthcare Provider Details

I. General information

NPI: 1790293454
Provider Name (Legal Business Name): TREEHOUSE DENTAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2018
Last Update Date: 07/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11055 ALPINE HWY. STE. 1
HIGHLAND UT
84003-8924
US

IV. Provider business mailing address

11055 ALPINE HWY. STE. 1
HIGHLAND UT
84003-8924
US

V. Phone/Fax

Practice location:
  • Phone: 801-756-2273
  • Fax: 801-208-0535
Mailing address:
  • Phone: 801-756-2273
  • Fax: 801-208-0535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ELIZA D COLLINS
Title or Position: OFFICE MANAGER
Credential:
Phone: 801-756-2273