Search icon

Club 32 Dental, PLLC

Company claim

Is this your business?

Get access!

Company Details

Name: Club 32 Dental, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 21 Jun 2020 (5 years ago)
Financial Date End: 30 Jun 2026
Entity Number: 3913012
Place of Formation: IDAHO
File Number: 714407
ZIP code: 83651
County: Canyon County
Principal Address: 624 3RD ST SOUTH NAMPA, ID 83651
Mailing Address: 624 3RD ST S NAMPA, ID 83651-3840

Agent

Name Role Address
KIM B KELLER Agent 607 2ND ST SOUTH, NAMPA, ID 83651

Manager

Name Role Address Appointed On
Kim B Keller Manager 450 W ISLAND CT, NAMPA, ID 83651 2021-05-04

National Provider Identifier

NPI Number:
1720698608
Certification Date:
2022-02-24

Authorized Person:

Name:
KIM BENSON KELLER
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QD0000X - Dental Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2083180227

Filing

Filing Name Filing Number Filing date
Annual Report 0006232353 2025-05-04
Annual Report 0005762484 2024-06-05
Annual Report 0005218542 2023-05-03
Annual Report 0004725504 2022-05-03
Annual Report 0004268023 2021-05-04

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 18 May 2025

Sources: Idaho Secretary of State