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PRIEST RIVER DENTAL CARE

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Company Details

Name: PRIEST RIVER DENTAL CARE
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 29 May 2008 (17 years ago)
Entity Number: 374894
Place of Formation: IDAHO
File Number: 0000374894
ZIP code: 83856
County: Bonner County
Mailing Address: 314 E ALBENI HWY PRIEST RIVER, ID 83856

National Provider Identifier

NPI Number:
1518683598
Certification Date:
2022-10-12

Authorized Person:

Name:
MRS. ALISON ASHLEY LAMBERT
Role:
OFFICE MANANGER
Phone:

Taxonomy:

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

Contacts:

Fax:
2084481703

Filing

Filing Name Filing Number Filing date
Amendment of Certificate of Assumed Business Name 0000876090 2010-12-16
Initial Filing 0000374894 2008-05-29

USAspending Awards / Financial Assistance

Date:
2020-04-19
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
15000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

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Date of last update: 25 Sep 2024

Sources: Idaho Secretary of State