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SOUTH RAINIER DENTISTRY, PLLC

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Company Details

Legal Name: SOUTH RAINIER DENTISTRY, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: September 7th 2007
Date of Dissolution: March 2nd 2012
Expiration date: 30 Sep 2012
UBI Number: 602 759 889
ZIP code: 98118
City: Seattle
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 8730 RAINIER AVE S, SEATTLE, WA, 98118, UNITED STATES

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Registered Agent Information

Name Role Address
DAT NGUYEN DDS Registered Agent 8730 RAINIER AVE S, SEATTLE, WA, 98118, UNITED STATES

Key Officers & Management

Name Role Address
DAT NGUYEN Governing Person 3506 WELLS AVE S, SEATTLE, WA, 98055, UNITED STATES
DAT NGUYEN DDS EXECUTOR 8730 RAINIER AVE S, SEATTLE, WA, 98118, UNITED STATES

National Provider Identifier

NPI Number:
1043503071

Authorized Person:

Name:
DR. DAT KHOA NGUYEN
Role:
MEMBER, MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
No
Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fax:
2067215947
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