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EAGLE ANESTHESIA & ORAL SURGERY PLLC

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Company Details

Name: EAGLE ANESTHESIA & ORAL SURGERY PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 21 Aug 2023 (2 years ago)
Financial Date End: 31 Aug 2025
Entity Number: 5367845
Place of Formation: IDAHO
File Number: 894348
ZIP code: 83616
County: Ada County
Principal Address: 197 W STATE ST EAGLE, ID 83616
Mailing Address: 5266 N EAGLE RD BOISE, ID 83713

Agent

Name Role Address
RYAN JUDD Agent 37 W ARCHERFIELD ST, 100, MERIDIAN, ID 83646

Manager

Name Role Address Appointed On
RYAN JUDD Manager 37 W ARCHERFIELD STREET, MERIDIAN, ID 83646 2024-09-14

National Provider Identifier

NPI Number:
1972333565
Certification Date:
2024-08-07

Authorized Person:

Name:
RYAN JUDD
Role:
DENTIST ANESTHESIOLOGIST
Phone:

Taxonomy:

Selected Taxonomy:
1223D0004X - Dentist Anesthesiologist
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005900464 2024-09-14
Initial Filing 0005367845 2023-08-21

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Date of last update: 27 Mar 2025

Sources: Idaho Secretary of State