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SEASONS DENTAL

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Company Details

Name: SEASONS DENTAL
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 08 Jun 2018 (7 years ago)
Entity Number: 612776
Place of Formation: IDAHO
File Number: 0000612776
ZIP code: 83318
County: Cassia County
Mailing Address: 425 N OVERLAND AVE BURLEY, ID 83318

National Provider Identifier

NPI Number:
1982157962

Authorized Person:

Name:
DR. TRAVIS T BODILY
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Initial Filing 0000612776 2018-06-08

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Date of last update: 26 Sep 2024

Sources: Idaho Secretary of State