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DENTAL PARTNERS USTICK, PLLC

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Company Details

Name: DENTAL PARTNERS USTICK, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 20 Jan 2016 (9 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 489065
Place of Formation: IDAHO
File Number: 489065
ZIP code: 83605
County: Canyon County
Principal Address: 4403 E USTICK RD STE 104 CALDWELL, ID 83605
Mailing Address: STE 104 4403 E USTICK RD CALDWELL, ID 83605-6843

Agent

Name Role Address
JASON HAMMER Agent 203 7TH AVE SOUTH, NAMPA, ID 83651

Member

Name Role Address Appointed On
Klint Keller Member MAN O WAR WAY, NAMPA, ID 83686 2021-01-21

National Provider Identifier

NPI Number:
1841643533

Authorized Person:

Name:
DR. KLINT KELLER
Role:
DR
Phone:

Taxonomy:

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

Contacts:

Fax:
2084756599

Filing

Filing Name Filing Number Filing date
Annual Report 0006006815 2024-12-04
Annual Report 0005495947 2023-12-04
Annual Report 0005016175 2022-12-06
Annual Report 0004587133 2022-02-01
Annual Report 0004140806 2021-01-21

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Date of last update: 12 May 2025

Sources: Idaho Secretary of State