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MOUNTAIN RIVER DENTAL PLLC

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Company Details

Name: MOUNTAIN RIVER DENTAL PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 06 Aug 2013 (12 years ago)
Financial Date End: 31 Aug 2025
Entity Number: 391686
Place of Formation: IDAHO
File Number: 391686
ZIP code: 83455
County: Teton County
Principal Address: 7726 LUPINE LN VICTOR, ID 83455-5116

Agent

Name Role Address
TRISTAN TAYLOR Agent 7726 LUPINE DR, VICTOR, ID 83455

Member

Name Role Address Appointed On
Tristan Taylor Member 7726 LUPINE LN, VICTOR, ID 83455-5116 2020-09-02

National Provider Identifier

NPI Number:
1093147696

Authorized Person:

Name:
DR. CURTIS W CARPENTER
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
122300000X - Dentist
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005812306 2024-07-08
Dissolution/Revocation - Administrative 0005473172 2023-11-09
Application for Reinstatement 0005474942 2023-11-09
Annual Report 0004916287 2022-09-15
Annual Report 0004416923 2021-09-13

Paycheck Protection Program

Jobs Reported:
5
Initial Approval Amount:
$41,400
Date Approved:
2020-04-13
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$41,400
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$41,736.87
Servicing Lender:
KeyBank National Association
Use of Proceeds:
Payroll: $41,400

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Date of last update: 20 Jul 2025

Sources: Idaho Secretary of State