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NORTH COLLEGE DENTAL

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Company Details

Name: NORTH COLLEGE DENTAL
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 13 Oct 2011 (14 years ago)
Entity Number: 458546
Place of Formation: IDAHO
File Number: 0000458546
ZIP code: 83301
County: Twin Falls County
Mailing Address: 1036 SKYLINE DR TWIN FALLS, ID 83301

National Provider Identifier

NPI Number:
1336313683

Authorized Person:

Name:
MARNI PETERSON
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fax:
2087367214

Filing

Filing Name Filing Number Filing date
Initial Filing 0000458546 2011-10-13

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Date of last update: 26 Sep 2024

Sources: Idaho Secretary of State