M VIRK DMD, PLLC

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Company Details

Legal Name:

M VIRK DMD, PLLC

Jurisdiction:

WASHINGTON

Entity Type:

WA PROFESSIONAL LIMITED LIABILITY COMPANY

Category:

DOMESTIC ENTITY

Status:

Active

Formation/ Registration Date:

June 22nd 2022

Expiration date:

30 Jun 2026

UBI Number:

604 933 162

ZIP code:

98374

City:

Puyallup

County:

PIERCE

Home State:

WASHINGTON

Principal Office Street Address:

10317 122ND ST E STE B, PUYALLUP, WA, 98374-2632, UNITED STATES

Contact Details

E-Mail:

LAUREN@BROCKLF.COM

Registered Agent Information

Name	Role	Address
COREY F. BROCK	Registered Agent	111 S POST ST STE 2280, SPOKANE, WA, 99201-4900, UNITED STATES

Name

Role

Address

COREY F. BROCK

Registered Agent

111 S POST ST STE 2280, SPOKANE, WA, 99201-4900, UNITED STATES

Key Officers & Management

Name	Role	Address
MAHADEEP VIRK	Governing Person	-
MAHADEEP S VIRK	EXECUTOR	19630 SE 184TH ST, RENTON, WA, 98058-0627, UNITED STATES

Name

Role

Address

MAHADEEP VIRK

Governing Person

MAHADEEP S VIRK

EXECUTOR

19630 SE 184TH ST, RENTON, WA, 98058-0627, UNITED STATES

National Provider Identifier

NPI Number:

1629706502

Certification Date:

2022-08-09

Link:

View on NPI website

Authorized Person:

Name:

BRENDA GRAY

Role:

OFFICE MANAGER

Phone:

2532367456

Taxonomy:

Selected Taxonomy:

122300000X - Dentist

Is Primary:

Yes

Contacts:

M VIRK DMD, PLLC

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M VIRK DMD, PLLC

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Company Details

Contact Details

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Key Officers & Management

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Contacts:

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