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RIVERSIDE DENTAL, PC

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Company Details

Name: RIVERSIDE DENTAL, PC
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 04 Oct 2001 (24 years ago)
Financial Date End: 31 Oct 2010
Date dissolved: 06 Jan 2011
Entity Number: 429667
Place of Formation: IDAHO
File Number: 0000429667
ZIP code: 83221
County: Bingham County
Mailing Address: 1120 PARKWAY DR BLACKFOOT, ID 83221

National Provider Identifier

NPI Number:
1053321885

Authorized Person:

Name:
DR. BRADFORD WILLIAM HARPER
Role:
OWNER/PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
122300000X - Dentist
Is Primary:
Yes

Contacts:

Fax:
2087850878

Filing

Filing Name Filing Number Filing date
Annual Report 0002829699 2009-08-17
Annual Report 0002829707 2008-08-18
Annual Report 0002829706 2007-08-13
Annual Report 0002829698 2006-08-10
Annual Report 0002829697 2005-08-12

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Date of last update: 25 Sep 2024

Sources: Idaho Secretary of State