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MOUNTAIN RIVER DENTAL

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Company Details

Name: MOUNTAIN RIVER DENTAL
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Inactive-Cancelled
Date of registration: 26 Jun 2009 (16 years ago)
Entity Number: 402854
Place of Formation: IDAHO
File Number: 0000402854
ZIP code: 83442
County: Jefferson County
Mailing Address: 3877 E 400 N RIGBY, ID 83442

National Provider Identifier

NPI Number:
1912136433

Authorized Person:

Name:
DR. RICHARD H GEORGE
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Fax:
2087878101

Filing

Filing Name Filing Number Filing date
Cancellation of Certificate of Assumed Business Name 0000886030 2013-08-13
Initial Filing 0000402854 2009-06-26

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Date of last update: 25 Sep 2024

Sources: Idaho Secretary of State