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CHERRY LANE KIDS DENTISTRY P.C.

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Company Details

Name: CHERRY LANE KIDS DENTISTRY P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 22 Sep 2017 (8 years ago)
Financial Date End: 30 Sep 2026
Entity Number: 632760
Place of Formation: IDAHO
File Number: 632760
ZIP code: 83642
County: Ada County
Mailing Address: STE A 1558 N. CRESTMONT DR. MERIDIAN, ID 83642

Agent

Name Role Address
C T CORPORATION SYSTEM Agent 10020 W FAIRVIEW AVE, STE 104, BOISE, ID 83704

President

Name Role Address Appointed On
Zane Palmer President 1558 N CRESTMONT DR, MERIDIAN, ID 83642-2194 2020-08-05

Director

Name Role Address Appointed On Resigned On
Zane Palmer Director 1558 N CRESTMONT DR STE A, MERIDIAN, ID 83642 2023-08-03 2024-08-12

National Provider Identifier

NPI Number:
1902325749

Authorized Person:

Name:
MS. RHONDA MARIE ELQUIST
Role:
REGIONAL OPERATIONS MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
1223P0221X - Pediatric Dentist
Is Primary:
Yes

Contacts:

Fax:
2085872624

Filing

Filing Name Filing Number Filing date
Annual Report 0006398901 2025-08-12
Registered Agent Name/Address Change (mass change) 0006277964 2025-05-27
Annual Report 0005856039 2024-08-12
Annual Report 0005345232 2023-08-03
Registered Agent Name/Address Change (mass change) 0004900789 2022-09-12

USAspending Awards / Financial Assistance

Date:
2020-08-12
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:
-26600.00
Total Face Value Of Loan:
0.00

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Date of last update: 15 Aug 2025

Sources: Idaho Secretary of State