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NG RUSSELL DDS PC

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Company Details

Legal Name: NG RUSSELL DDS PC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Delinquent
Formation/ Registration Date: June 2nd 2020
Expiration date: 30 Jun 2025
UBI Number: 604 620 426
ZIP code: 98110
City: Bainbridge Island
County: KITSAP
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 945 HILDEBRAND LN NE STE 230, BAINBRIDGE IS, WA, 98110-3080, UNITED STATES

Contact Details

E-Mail: RUSSELLDDS@YAHOO.COM
Phone Number: +1 206-280-7070

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
NATHAN RUSSELL Registered Agent 945 HILDEBRAND LN NE STE 230, BAINBRIDGE IS, WA, 98110-3080, UNITED STATES

Key Officers & Management

Name Role Address
NATHAN RUSSELL Incorporator 945 HILDEBRAND LN NE STE 230, BAINBRIDGE IS, WA, 98110-3080, UNITED STATES
NATHAN RUSSELL Governing Person 945 HILDEBRAND LN NE, STE 230, BAINBRIDGE ISLAND, WA, 98110, UNITED STATES

National Provider Identifier

NPI Number:
1184230294
Certification Date:
2020-09-23

Authorized Person:

Name:
DR. NATHAN RUSSELL
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QD0000X - Dental Clinic/Center
Is Primary:
Yes

Contacts:

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