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TETON OBSTETRICS AND GYNECOLOGY PA

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Company Details

Name: TETON OBSTETRICS AND GYNECOLOGY PA
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 17 Feb 2015 (10 years ago)
Financial Date End: 28 Feb 2026
Entity Number: 617844
Place of Formation: IDAHO
File Number: 617844
ZIP code: 83404
County: Bonneville County
Mailing Address: STE 10 2001 S WOODRUFF AVE IDAHO FALLS, ID 83404-6372

Agent

Name Role Address
WILLIAM NICK DENSON MD Agent 2001 S WOODRUFF AVE STE 10, IDAHO FALLS, ID 83404

President

Name Role Address Appointed On
Teton Obstetrics and Gynecology President 2001 S WOODRUFF, IDAHO FALLS, ID 83404 2021-01-04

National Provider Identifier

NPI Number:
1780043042

Authorized Person:

Name:
KATIE DAVENPORT
Role:
BILLING
Phone:

Taxonomy:

Selected Taxonomy:
207V00000X - Obstetrics & Gynecology Physician
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006055990 2025-01-08
Annual Report 0005536771 2024-01-03
Annual Report 0005078425 2023-01-23
Annual Report 0004555514 2022-01-05
Annual Report 0004114818 2021-01-04

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Date of last update: 16 May 2025

Sources: Idaho Secretary of State