Individual
EASTON JOHNSON TREJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648-1062
(208) 828-7300
Mailing address
8447 BEAR LOOP, MOUNTAIN HOME AFB, ID 83648-5101
(512) 963-0859
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
13899316-9925
UT
1223G0001X
General Practice Dentistry
Primary
37873
TX
1223G0001X
General Practice Dentistry
D-5603
ID
Other
Enumeration date
03/04/2021
Last updated
07/28/2025
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