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WAYNE R. PETERSON, DMD, P.C.

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Company Details

Name: WAYNE R. PETERSON, DMD, P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 06 Nov 2002 (23 years ago)
Financial Date End: 30 Nov 2014
Date dissolved: 10 Feb 2015
Entity Number: 444966
Place of Formation: IDAHO
File Number: 0000444966
ZIP code: 83704
County: Ada County
Mailing Address: 2427 N COLE RD BOISE, ID 83704

National Provider Identifier

NPI Number:
1205083714

Authorized Person:

Name:
DR. WAYNE R PETERSON
Role:
PRESIDENT
Phone:

Taxonomy:

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

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0002885989 2013-09-30
Annual Report 0002885988 2012-10-09
Annual Report 0002885995 2011-09-29
Annual Report 0002885994 2010-11-01
Annual Report 0002885993 2009-10-10

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Date of last update: 26 Sep 2024

Sources: Idaho Secretary of State