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TOWN SQUARE DENTAL PARTNERS, PLLC

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Company Details

Name: TOWN SQUARE DENTAL PARTNERS, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 25 Jul 2016 (9 years ago)
Financial Date End: 31 Jul 2026
Entity Number: 514365
Place of Formation: IDAHO
File Number: 514365
ZIP code: 83651
County: Canyon County
Principal Address: 203 7TH AVE S NAMPA, ID 83651
Mailing Address: 203 7TH AVE S NAMPA, ID 83651-3846

Agent

Name Role Address
KLINT KELLER Agent 207 7TH AVE S, NAMPA, ID 83651

Manager

Name Role Address Appointed On Resigned On
Sean Wasden Manager 2014 WEST SILVER CREEK DRIVE, NAMPA, ID 83686 2020-08-13 No data
Kim Keller Manager 624 3RD ST S, NAMPA, ID 83651 2024-06-05 2024-06-05

Member

Name Role Address Appointed On Resigned On
Jason Hammer Member 203 7TH AVE SOUTH, NAMPA, ID 83651 2024-06-05 2024-06-05

National Provider Identifier

NPI Number:
1831678903

Authorized Person:

Name:
DR. KLINT R KELLER
Role:
OWNER/DOCTOR
Phone:

Taxonomy:

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

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
814233917
Plan Year:
2020
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
1
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006300363 2025-06-05
Annual Report 0005762493 2024-06-05
Annual Report 0005265406 2023-06-05
Annual Report 0004771300 2022-06-06
Annual Report 0004309441 2021-06-08

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Date of last update: 07 Jun 2025

Sources: Idaho Secretary of State