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CHOICE DENTAL PC

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Company Details

Name: CHOICE DENTAL PC
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 24 Apr 2017 (8 years ago)
Financial Date End: 30 Apr 2026
Entity Number: 631163
Place of Formation: IDAHO
File Number: 631163
ZIP code: 83402
County: Bonneville County
Mailing Address: 1991 W BROADWAY ST IDAHO FALLS, ID 83402-3041

Agent

Name Role Address
Daniel Packard Agent 1000 RIVERWALK DR, STE 100, IDAHO FALLS, ID 83402

President

Name Role Address Appointed On Resigned On
TRENT KELLY President 1991 W BROADWAY ST, IDAHO FALLS, ID 83402-3041 2021-07-20 2023-03-23
TRENT KELLY President 1991 W BROADWAY ST, IDAHO FALLS, ID 83402-3041 2025-03-04 No data

National Provider Identifier

NPI Number:
1255906277
Certification Date:
2021-05-21

Authorized Person:

Name:
DR. TRENT M KELLY
Role:
DENTIST
Phone:

Taxonomy:

Selected Taxonomy:
124Q00000X - Dental Hygienist
Is Primary:
No
Selected Taxonomy:
122300000X - Dentist
Is Primary:
Yes

Contacts:

Fax:
2083574911

Filing

Filing Name Filing Number Filing date
Annual Report 0006140422 2025-03-04
Application for Reinstatement 0005813753 2024-07-09
Dissolution/Revocation - Administrative 0005807278 2024-07-06
Annual Report 0005166245 2023-03-23
Annual Report 0004740025 2022-05-09

USAspending Awards / Financial Assistance

Date:
2021-02-10
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
47772.00
Total Face Value Of Loan:
47772.00
Date:
2020-05-03
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
32704.00
Total Face Value Of Loan:
32704.00
Date:
2020-04-29
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
8000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

Paycheck Protection Program

Date Approved:
2021-02-10
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
47772
Current Approval Amount:
47772
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
48495.78
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
32704
Current Approval Amount:
32704
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
33198.59

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Date of last update: 06 Jul 2025

Sources: Idaho Secretary of State