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MOSS FAMILY DENTISTRY, P.A.

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Company Details

Name: MOSS FAMILY DENTISTRY, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 05 Feb 2009 (16 years ago)
Financial Date End: 28 Feb 2026
Date dissolved: 13 May 2025
Entity Number: 549855
Place of Formation: IDAHO
File Number: 549855
ZIP code: 83815
County: Kootenai County
Mailing Address: 4454 W LENNOX LOOP COEUR D ALENE, ID 83815-8718

Agent

Name Role Address
DAVID MOSS Agent 4454 W LENNOX LOOP, COEUR D ALENE, ID 83815

President

Name Role Address Appointed On
David Moss President 317 N FLATHEAD LN, IDAHO FALLS, ID 83401 2021-01-05

National Provider Identifier

NPI Number:
1568601250

Authorized Person:

Name:
DR. DAVID L MOSS
Role:
PRESIDENT
Phone:

Taxonomy:

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

Contacts:

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0006253015 2025-05-13
Dissolution/Revocation - Administrative 0006252658 2025-05-13
Annual Report 0005604310 2024-02-15
Annual Report 0005077238 2023-01-21
Annual Report 0004551673 2022-01-03

Paycheck Protection Program

Jobs Reported:
8
Initial Approval Amount:
$72,140
Date Approved:
2020-04-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$72,140
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$72,993.82
Servicing Lender:
Glacier Bank
Use of Proceeds:
Payroll: $72,140

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Date of last update: 03 Jul 2025

Sources: Idaho Secretary of State