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SILVER LAKE ORTHODONTICS

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Company Details

Legal Name: SILVER LAKE ORTHODONTICS
Jurisdiction: WASHINGTON
Entity Type: WA NONPROFIT PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: November 20th 2018
Date of Dissolution: April 3rd 2022
Expiration date: 30 Nov 2021
UBI Number: 604 364 365
ZIP code: 98208
City: Everett
County: SNOHOMISH
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 10812 19TH AVE SE, EVERETT, WA, 98208-5153, UNITED STATES

Contact Details

E-Mail: BRACES@SEANET.COM
Phone Number: +1 425-338-5744

Nature of Business

Any Lawful Purpose, Charitable, ORTHODONTIC CORRECTION OF INDIGENT CHILDREN

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Registered Agent Information

Name Role Address
SILVERLAKEORTHODONTICS Registered Agent 10812 19TH AVE SE, EVERETT, WA, 98208-5153, UNITED STATES

Key Officers & Management

Name Role Address
TAMI ROWE Governing Person -
WILLIAM OLIVER Governing Person 10812 19TH AVE SE, EVERETT, WA, 98208-5153, UNITED STATES
PETER WALDEN Initial Board Of Director 10812 19TH AVE SE, EVERETT, WA, 98208-5153, UNITED STATES
WILLIAM OLIVER Initial Board Of Director 10812 19TH AVE SE, EVERETT, WA, 98208-5153, UNITED STATES
PETER WALDEN Incorporator 10812 19TH AVE SE, EVERETT, WA, 98208-5153, UNITED STATES

National Provider Identifier

NPI Number:
1972113652
Certification Date:
2020-08-06

Authorized Person:

Name:
DR. WILLIAM OLIVER
Role:
CEO AND OWNER
Phone:

Taxonomy:

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

Contacts:

Fax:
4253385744
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