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WILSON DENTAL, PLLC

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Company Details

Name: WILSON DENTAL, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 13 Oct 2017 (8 years ago)
Financial Date End: 31 Oct 2025
Entity Number: 575021
Place of Formation: IDAHO
File Number: 575021
ZIP code: 83634
County: Ada County
Principal Address: 5100 E KIWI CT KUNA, ID 83634
Mailing Address: STE 107 10497 W GARVERDALE CT BOISE, ID 83704-5468

Agent

Name Role Address
GREGG A WILSON Agent 5100 E KIWI CT, KUNA, ID 83634

Manager

Name Role Address Appointed On
Kami Wilson Manager 5100 E KIWI CT, KUNA, ID 83634 2020-10-06

National Provider Identifier

NPI Number:
1265935902

Authorized Person:

Name:
DR. GREGG ANDREW WILSON
Role:
DENTIST/CEO
Phone:

Taxonomy:

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

Contacts:

Fax:
2083238538

Filing

Filing Name Filing Number Filing date
Annual Report 0005895729 2024-09-10
Annual Report 0005381764 2023-09-05
Annual Report 0004886520 2022-09-06
Annual Report 0004409184 2021-09-07
Annual Report 0004025851 2020-10-06

Paycheck Protection Program

Date Approved:
2020-04-06
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
87900
Current Approval Amount:
77200
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
77737.23

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Date of last update: 04 Jul 2025

Sources: Idaho Secretary of State