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TETON VALLEY DENTAL CENTER, PLLC

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Company Details

Name: TETON VALLEY DENTAL CENTER, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 22 Feb 2010 (15 years ago)
Financial Date End: 28 Feb 2014
Date dissolved: 14 May 2014
Entity Number: 282174
Place of Formation: IDAHO
File Number: 0000282174
ZIP code: 83404
County: Bonneville County
Principal Address: 2105 CORONADO ST IDAHO FALLS, ID 83404

National Provider Identifier

NPI Number:
1063783868

Authorized Person:

Name:
JAMES C ALLEN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261QD0000X - Dental Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QD0000X - Dental Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2083548182

Filing

Filing Name Filing Number Filing date
Annual Report 0002128095 2013-02-28
Legacy Amendment 0000836398 2012-05-03
Annual Report 0002128094 2011-12-14
Annual Report 0002128093 2011-03-03
Initial Filing 0000282174 2010-02-22

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Date of last update: 24 Sep 2024

Sources: Idaho Secretary of State