# TREE CITY FAMILY DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891304002
- **Authorized official:** DUSTIN CONNAUGHTON DDS (DENTIST/OWNER)
- **Authorized official phone:** (208) 286-2699

## Contact information

- **Practice address:** 7301 W. EMERALD ST STE. 102, BOISE, ID 83704
- **Practice address phone:** (208) 286-2699
- **Practice address fax:** (208) 350-6526
- **Mailing address:** 7301 W. EMERALD ST STE. 102, BOISE, ID 83704
- **Mailing address phone:** (208) 286-2699
- **Mailing address fax:** (208) 350-6526

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 07/24/2020
- **Last updated:** 07/24/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9200495 | — | ID |