Provider Demographics
NPI:1790293454
Name:TREEHOUSE DENTAL INC
Entity type:Organization
Organization Name:TREEHOUSE DENTAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZA
Authorized Official - Middle Name:D
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-756-2273
Mailing Address - Street 1:11055 ALPINE HWY.
Mailing Address - Street 2:STE. 1
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-8924
Mailing Address - Country:US
Mailing Address - Phone:801-756-2273
Mailing Address - Fax:801-208-0535
Practice Address - Street 1:11055 ALPINE HWY.
Practice Address - Street 2:STE. 1
Practice Address - City:HIGHLAND
Practice Address - State:UT
Practice Address - Zip Code:84003-8924
Practice Address - Country:US
Practice Address - Phone:801-756-2273
Practice Address - Fax:801-208-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-16
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT4253033Medicaid