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  5. BRYCE LARSEN, DMD, PLLC

BRYCE LARSEN, DMD, PLLC

Company Details

Name: BRYCE LARSEN, DMD, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 04 Sep 2008 (17 years ago)
Financial Date End: 30 Sep 2025
Entity Number: 242412
Place of Formation: IDAHO
File Number: 242412
ZIP code: 83201
County: Bannock County
Principal Address: 950 HOSPITAL WAY STE B POCATELLO, ID 83201
Mailing Address: MONICA WHITE STE B 950 HOSPITAL WAY POCATELLO, ID 83201-2762

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LARSEN DENTAL 401(K) PLAN 2014 263306896 2015-10-13 BRYCE LARSEN DMD PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 2082337007
Plan sponsor’s address 950 HOSPITAL WAY, SUITE B, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing BRYCE LARSEN
Valid signature Filed with authorized/valid electronic signature
LARSEN DENTAL 401(K) PLAN 2014 263306896 2015-09-02 BRYCE LARSEN DMD PLLC 10
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 2082337007
Plan sponsor’s address 950 HOSPITAL WAY, SUITE B, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2015-09-02
Name of individual signing BRYCE LARSEN
Valid signature Filed with authorized/valid electronic signature
LARSEN DENTAL LLC 401(K) PLAN 2014 263306896 2015-10-12 BRYCE LARSEN DMD PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 2082337007
Plan sponsor’s address 950 HOSPITAL WAY, SUITE B, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2015-10-12
Name of individual signing BRYCE LARSEN
Valid signature Filed with authorized/valid electronic signature
LARSEN DENTAL LLC 401(K) PLAN 2013 263306896 2014-10-08 BRYCE LARSEN DMD PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 2082337007
Plan sponsor’s address 950 HOSPITAL WAY, SUITE B, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2014-10-08
Name of individual signing BRYCE LARSEN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DAVE BAGLEY Agent 201 E CENTER ST, POCATELLO, ID 83201

Manager

Name Role Address Appointed On
Bryce R Larsen Manager 950 HOSPITAL WAY, POCATELLO, ID 83201 2020-08-11

Filing

Filing Name Filing Number Filing date
Annual Report 0005853437 2024-08-09
Annual Report 0005357950 2023-08-08
Annual Report 0004855069 2022-08-10
Annual Report 0004374062 2021-08-09
Annual Report 0003969123 2020-08-11
Annual Report 0003608027 2019-08-28
Annual Report 0001904817 2018-07-31
Annual Report 0001904816 2017-09-19
Annual Report 0001904815 2016-07-25
Annual Report 0001904814 2015-07-27

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
2589587201 2020-04-16 1087 PPP 950 Hospital Way Suite B, POCATELLO, ID, 83201
Loan Status Date 2021-11-11
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 69100
Loan Approval Amount (current) 69100
Undisbursed Amount 0
Franchise Name -
Lender Location ID 72601
Servicing Lender Name Zions Bank, A Division of
Servicing Lender Address 1 S Main St, SALT LAKE CITY, UT, 84133-1109
Rural or Urban Indicator U
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address POCATELLO, BANNOCK, ID, 83201-1800
Project Congressional District ID-02
Number of Employees 12
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 72601
Originating Lender Name Zions Bank, A Division of
Originating Lender Address SALT LAKE CITY, UT
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 70141.23
Forgiveness Paid Date 2021-10-21
3528878703 2021-03-31 1087 PPS 950 Hospital Way, Pocatello, ID, 83201-2789
Loan Status Date 2021-10-14
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 64289
Loan Approval Amount (current) 64289
Undisbursed Amount 0
Franchise Name -
Lender Location ID 72601
Servicing Lender Name Zions Bank, A Division of
Servicing Lender Address 1 S Main St, SALT LAKE CITY, UT, 84133-1109
Rural or Urban Indicator U
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address Pocatello, BANNOCK, ID, 83201-2789
Project Congressional District ID-02
Number of Employees 18
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 72601
Originating Lender Name Zions Bank, A Division of
Originating Lender Address SALT LAKE CITY, UT
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 64618.37
Forgiveness Paid Date 2021-10-06

Related by officers

DAVE BAGLEY

NTEAM, LLLP MULLEN PROPERTIES, LLLP FREEMAN VENTURES, LLC FREEMAN HOLDINGS, LLC BON CHOCOLAT, LLC SWEENEY RANDOLPH, LLC NORTH ARTHUR, LLC HWY 30, LLC SYRINGA PARTNERS, LLC MULLEN INVESTMENTS, LLC

Bryce R Larsen

TCAFE, LLC A.M. START, LLC Tiny Village on Main, LLC TCDOE, LLC

Related by address

950 HOSPITAL WAY STE B POCATELLO, ID 83201

STONE RIDGE PROFESSIONAL PLAZA, LLC TCDOE, LLC LARSEN DENTAL CARE OF GRACE DYNAMIC DENTAL SOLUTIONS, LLC A.M. START, LLC

MONICA WHITE STE B 950 HOSPITAL WAY POCATELLO, ID 83201-2762

TCDOE, LLC

Date of last update: 02 Apr 2025

Sources: Idaho Secretary of State

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