BONNEY LAKE DENTAL, LLC

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Company Details

Legal Name:	BONNEY LAKE DENTAL, LLC
Jurisdiction:	WASHINGTON
Entity Type:	WA LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	June 15th 2018
Expiration date:	30 Jun 2026
UBI Number:	604 300 684
ZIP code:	98391
City:	Bonney Lake
County:	PIERCE
Home State:	WASHINGTON
Principal Office Street Address:	19657 STATE ROUTE 410 E, BONNEY LAKE, WA, 98391-5202, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$22,625

Contact Details

E-Mail:

REGISTEREDAGENT@CAIRNCROSS.COM

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
CAIRNCROSS & HEMPELMANN, P.S.	Registered Agent	524 2ND AVE STE 500, SEATTLE, WA, 98104-2323, UNITED STATES

Key Officers & Management

Name	Role	Address
MARGARET BREEN	Executor	524 2ND AVE, SUITE 500, SEATTLE, WA, 98104-2323, UNITED STATES
DAVID CHAMBERLAIN	Governing Person	-
AARON BROOKS	Governing Person	-

National Provider Identifier

NPI Number:

1073088423

Link:

View on NPI website

Authorized Person:

Name:

TRAVIS PROBST

Role:

OWNER /DENTIST

Phone:

7193525773

Taxonomy:

Selected Taxonomy:

261QD0000X - Dental Clinic/Center

Is Primary:

Yes

Contacts:

Phone:

+1 253-780-7003

Form 5500 Series

Employer Identification Number (EIN):

830916176

Plan Year:

2024

Number Of Participants:

26

Plan Name:

401(K)

Sponsor's telephone number:

2537807003

File:

Plan Administrator / Signatory:

DAVID CHAMBERLAIN(Plan administrator)

Plan Year:

2023

Number Of Participants:

13

Plan Name:

401(K)

Sponsor's telephone number:

2537807003

File:

Plan Administrator / Signatory:

DAVID CHAMBERLAIN(Plan administrator)

Plan Year:

2022

Number Of Participants:

22

Plan Name:

401(K)

Sponsor's telephone number:

2537807003

File:

Plan Administrator / Signatory:

CHRIS HORNE(Plan administrator)

Plan Year:

2021

Number Of Participants:

18

Plan Name:

401(K)

Sponsor's telephone number:

2537807003

File:

Plan Administrator / Signatory:

KAREN ZYRA(Plan administrator)

Paycheck Protection Program

Jobs Reported:

13

Initial Approval Amount:

$67,100

Date Approved:

2020-04-10

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$67,100

Race:

Asian

Ethnicity:

Unknown/NotStated

Gender:

Male Owned

Veteran:

Veteran

Forgiveness Amount:

$67,784.05

Servicing Lender:

FirstBank

Use of Proceeds:

Payroll: $67,100

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