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MATTHEW A. FOWLER, D.M.D., P.C.

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Company Details

Name: MATTHEW A. FOWLER, D.M.D., P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 20 Aug 2002 (23 years ago)
Financial Date End: 31 Aug 2022
Date dissolved: 05 Nov 2022
Entity Number: 442049
Place of Formation: IDAHO
File Number: 442049
ZIP code: 83686
County: Canyon County
Mailing Address: 909 SAGE CREEK RD NAMPA, ID 83686-8894

Agent

Name Role Address
MATTHEW A FOWLER DMD Agent 909 SAGE CREEK RD., NAMPA, ID 83686

President

Name Role Address Appointed On
Matthew A Fowler President 909 SAGE CREEK RD, NAMPA, ID 83686 2020-08-03

National Provider Identifier

NPI Number:
1548429434

Authorized Person:

Name:
DR. MATTHEW A FOWLER
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
1223E0200X - Endodontist
Is Primary:
Yes

Contacts:

Fax:
2084619024

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0004981307 2022-11-05
Annual Report 0004358381 2021-07-26
Annual Report 0003953932 2020-08-03
Annual Report 0003603193 2019-08-22
Annual Report 0002875537 2018-08-13

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Date of last update: 06 Jun 2025

Sources: Idaho Secretary of State