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SILVER LAKE DENTAL, PLLC

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Company Details

Name: SILVER LAKE DENTAL, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 15 Dec 2004 (21 years ago)
Financial Date End: 31 Dec 2019
Date dissolved: 14 Oct 2020
Entity Number: 118141
Place of Formation: IDAHO
File Number: 118141
ZIP code: 83814
County: Kootenai County
Principal Address: 2201 N GOVERNMENT WAY STE A COEUR D'ALENE, ID 83814
Mailing Address: STE A 2201 N GOVERNMENT WAY COEUR D ALENE, ID 83814-3658

Agent

Name Role Address
Tarena L Wadsworth Agent 2201 GOVERNMENT WAY, STE A, COEUR D ALENE, ID 83814

National Provider Identifier

NPI Number:
1851551345

Authorized Person:

Name:
MR. JAMES S HOUGH
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fax:
2087620531

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0004031746 2020-10-14
Application for Reinstatement 0003487321 2019-04-22
Dissolution/Revocation - Administrative 0003479491 2019-04-16
Annual Report 0001369305 2017-12-13
Annual Report 0001369304 2016-10-26

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Date of last update: 24 Jun 2025

Sources: Idaho Secretary of State