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KRISTIN KAELIN, DMD, P.C.

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Company Details

Legal Name: KRISTIN KAELIN, DMD, P.C.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: October 10th 2019
Date of Dissolution: March 3rd 2024
Expiration date: 31 Oct 2023
UBI Number: 604 526 038
ZIP code: 98632
City: Longview
County: COWLITZ
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 100 TRIANGLE SHOPPING CTR STE 185, LONGVIEW, WA, 98632-4683, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 629 DAVIS DR, SUITE 300, CHAMPAIGN, IL, 61827, UNITED STATES

Contact Details

E-Mail: LICENSES@AFFORDABLECARE.COM
Phone Number: +1 919-341-4211

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
NATIONAL REGISTERED AGENTS, INC. Registered Agent 711 CAPITOL WAY S STE 204, OLYMPIA, WA, 98501-1267, UNITED STATES

Key Officers & Management

Name Role Address
KRISTIN KAELIN Governing Person 629 DAVIS DR, STE 300, MORRISVILLE, NC, 27560-7889, UNITED STATES
ANNA LASSETER Governing Person -
JON VITIELLO Governing Person -
KRISTIN KAELIN INCORPORATOR 100 TRIANGLE SHOPPING CTR STE 185, LONGVIEW, WA, 98632-4683, UNITED STATES

National Provider Identifier

NPI Number:
1467113514
Certification Date:
2021-12-30

Authorized Person:

Name:
KRISTIN KAELIN
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Paycheck Protection Program

Jobs Reported:
4
Initial Approval Amount:
$11,937
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$11,937
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$12,081.88
Servicing Lender:
Bank of America, National Association
Use of Proceeds:
Payroll: $11,937
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