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Challis Dental, PLLC

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Company Details

Name: Challis Dental, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 03 Dec 2020 (5 years ago)
Financial Date End: 31 Dec 2025
Entity Number: 4084889
Place of Formation: IDAHO
File Number: 736136
ZIP code: 83226
County: Custer County
Principal Address: 121 S 12TH ST CHALLIS, ID 83226
Mailing Address: 262 N 4232 E RIGBY, ID 83442-5067

Agent

Name Role Address
Richard Dee Stoker Agent 262 N 4232 E, RIGBY, ID 83442

Manager

Name Role Address Appointed On
Richard Stoker Manager 262 N 4232 E, RIGBY, ID 83442 2021-11-03

National Provider Identifier

NPI Number:
1932793866
Certification Date:
2021-02-03

Authorized Person:

Name:
RICHARD DEE STOKER
Role:
MEMBER
Phone:

Taxonomy:

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

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005960188 2024-11-04
Annual Report 0005456254 2023-11-03
Annual Report 0004969783 2022-11-03
Annual Report 0004476444 2021-11-03
Initial Filing 0004084889 2020-12-03

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Date of last update: 18 May 2025

Sources: Idaho Secretary of State