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RUSSELL GUYMON ORTHODONTICS, PA

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Company Details

Name: RUSSELL GUYMON ORTHODONTICS, PA
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 29 Nov 2011 (14 years ago)
Financial Date End: 30 Nov 2014
Date dissolved: 10 Feb 2015
Entity Number: 582422
Place of Formation: IDAHO
File Number: 0000582422
ZIP code: 83401
County: Bonneville County
Mailing Address: 333 S WOODRUFF AVE IDAHO FALLS, ID 83401

National Provider Identifier

NPI Number:
1194097402

Authorized Person:

Name:
DR. RUSSELL J GUYMON
Role:
OWNER/ORTHODONTIST
Phone:

Taxonomy:

Selected Taxonomy:
1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0003244804 2013-09-26
Annual Report 0003244803 2012-12-17
Initial Filing 0000582422 2011-11-29

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Date of last update: 26 Sep 2024

Sources: Idaho Secretary of State