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PETER C. WAGNER, D.M.D., P.S.

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Company Details

Legal Name: PETER C. WAGNER, D.M.D., P.S.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: December 29th 1997
Date of Dissolution: May 3rd 2021
Expiration date: 31 Dec 2020
UBI Number: 601 841 315
ZIP code: 98532
City: Chehalis
County: LEWIS
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1292 S MARKET BLVD, CHEHALIS, WA, 98532-3645, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 1292 S MARKET BLVD, CHEHALIS, WA, 98532-0000, UNITED STATES

Contact Details

E-Mail: WAGNERORTHO@LOCALACCESS.COM
Phone Number: +1 360-748-6636

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
PETER C WAGNER DMD PS Registered Agent 1292 S MARKET BLVD, CHEHALIS, WA, 98532-0000, UNITED STATES

Key Officers & Management

Name Role
PETER WAGNER Governing Person
JULIE WAGNER Governing Person

National Provider Identifier

NPI Number:
1831320993

Authorized Person:

Name:
DR. PETER CARL WAGNER
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
911870793
Plan Year:
2019
Number Of Participants:
18
Plan Name:
401(K)
Sponsor's telephone number:
Plan Year:
2019
Number Of Participants:
2
Plan Name:
401(K)
Sponsor's telephone number:
Plan Year:
2018
Number Of Participants:
18
Plan Name:
401(K)
Sponsor's telephone number:
Plan Year:
2017
Number Of Participants:
17
Plan Name:
401(K)
Sponsor's telephone number:
Plan Year:
2016
Number Of Participants:
19
Plan Name:
401(K)
Sponsor's telephone number:
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