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North Alabama Prosthodontics, P.C.

Details

Name: North Alabama Prosthodontics, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Dissolved
Date of registration: 04 Oct 2011 (13 years ago) (Companies founded in October 2011)
Date of dissolution: 21 Feb 2017
Entity Number: 000-026-987
Register Number: 000026987
ZIP code: 35749 (Companies in Madison, 35749)
County: Madison
Place of Formation: Madison County
Registered Office Street Address: 101 EMERALD DRHARVEST, AL 35749
Authorized Capital: 1000 @ $.01 PV

Activities RENDER PROFESSIONAL DENTAL SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1710241724 2012-06-25 2012-06-25 807 REGAL DR SW, HUNTSVILLE, AL, 358015604, US 807 REGAL DR SW, HUNTSVILLE, AL, 358015604, US

Contacts

Phone +1 256-517-8071
Fax 2565178124

Authorized person

Name DR. AMANDA HEUSINGER PELTIER
Role PRESIDENT/PROSTHODONTIST
Phone 2565178071

Taxonomy

Taxonomy Code 261QD0000X - Dental Clinic/Center
License Number 5654
State AL
Is Primary Yes

Agent

Name Role Address
PELTIER, AMANDA Agent 101 EMERALD DRHARVEST, AL 35749

Director

Name Role Address
PELTIER, AMANDA Director 101 EMERALD DRHARVEST, AL 35749

Incorporator

Name Role Address
ANDERSON, BRAD S Incorporator 1819 5TH AVENUE NORTH, SUITE 1000BIRMINGHAM, AL 35203-1112

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State