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MOBILE DENTAL NORTHWEST LLC

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Company Details

Legal Name: MOBILE DENTAL NORTHWEST LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: January 17th 2012
Date of Dissolution: January 2nd 2014
Expiration date: 31 Jan 2014
UBI Number: 603 173 887
ZIP code: 98465
City: Tacoma
County: PIERCE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1622 SOUTH MILDRED, TACOMA, WA, 98465, UNITED STATES

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Registered Agent Information

Name Role Address
GREGORYFISHER Registered Agent 10003 CRESCENT VALLEY DR, GIG HARBOR, WA, 98332, UNITED STATES

Key Officers & Management

Name Role
GREGORY FISHER Governing Person
KATHLEEN SOYE-SUPPLEE Governing Person
LESLIE BREEDLOVE Governing Person

National Provider Identifier

NPI Number:
1700148152

Authorized Person:

Name:
DR. GREGORY ROBERT FISHER
Role:
VICE PRESIDENT- FINANCE
Phone:

Taxonomy:

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

Contacts:

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