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FOUR SEASON DENTAL, P.C.

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Company Details

Name: FOUR SEASON DENTAL, P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 25 Feb 2004 (21 years ago)
Financial Date End: 28 Feb 2026
Entity Number: 466012
Place of Formation: IDAHO
File Number: 466012
ZIP code: 83201
County: Bannock County
Mailing Address: 115 E CHAPEL RD POCATELLO, ID 83201-3540

Agent

Name Role Address
KIM SMITH Agent 115 E CHAPEL RD, POCATELLO, ID 83201

President

Name Role Address Appointed On
KIM SMITH President 115 E CHAPEL RD, POCATELLO, ID 83201 2021-02-11

National Provider Identifier

NPI Number:
1215102439

Authorized Person:

Name:
LIZ JOHN
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
No
Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fax:
2082376811

Form 5500 Series

Employer Identification Number (EIN):
200794339
Plan Year:
2021
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
8
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006105667 2025-02-11
Annual Report 0005562233 2024-01-15
Annual Report 0005079744 2023-01-24
Annual Report 0004568578 2022-01-13
Annual Report 0004172908 2021-02-11

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Date of last update: 09 Aug 2025

Sources: Idaho Secretary of State