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Three Lakes Dental, P.C.

Details

Name: Three Lakes Dental, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 19 Dec 2011 (13 years ago) (Companies founded in December 2011)
Entity Number: 000-034-083
Register Number: 000034083
ZIP code: 36078 (Companies in Elmore, 36078)
County: Elmore
Place of Formation: Elmore County
Registered Office Street Address: 1619 GILMER AVENUETALLASSEE, AL 36078
Authorized Capital: 1,000 @ $.01 PV

Activities PROFESSIONAL DENTAL SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1497002216 2012-08-10 2012-08-10 1619 GILMER AVE, TALLASSEE, AL, 360782313, US 1619 GILMER AVE, TALLASSEE, AL, 360782313, US

Contacts
Phone +1 334-252-9000
Fax 3342529003

Authorized person
Name DR. ERIC S HARRIS
Role OWNER, DENTIST
Phone 3342529000

Taxonomy
Taxonomy Code 1223G0001X - General Practice Dentistry
License Number 5796
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THREE LAKES DENTAL, P.C. 401(K) PLAN 2023 454131433 2024-06-17 THREE LAKES DENTAL, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 3342529000
Plan sponsor’s address 1619 GILMER AVENUE, TALLASSEE, AL, 36078
THREE LAKES DENTAL, P.C. 401(K) PLAN 2022 454131433 2023-04-11 THREE LAKES DENTAL, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 3342529000
Plan sponsor’s address 1619 GILMER AVENUE, TALLASSEE, AL, 36078
THREE LAKES DENTAL, P.C. 401(K) PLAN 2021 454131433 2022-05-10 THREE LAKES DENTAL, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 3342529000
Plan sponsor’s address 1619 GILMER AVENUE, TALLASSEE, AL, 36078
THREE LAKES DENTAL, P.C. 401(K) PLAN 2020 454131433 2021-06-25 THREE LAKES DENTAL, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 3342529000
Plan sponsor’s address 1619 GILMER AVENUE, TALLASSEE, AL, 36078
THREE LAKES DENTAL, P.C. 401(K) PLAN 2019 454131433 2020-05-26 THREE LAKES DENTAL, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 3342529000
Plan sponsor’s address 1619 GILMER AVENUE, TALLASSEE, AL, 36078

Signature of
Role Plan administrator
Date 2020-05-26
Name of individual signing JULIE S POSKE
THREE LAKES DENTAL, P.C. 401(K) PLAN 2018 454131433 2019-06-25 THREE LAKES DENTAL, P.C. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 3342529000
Plan sponsor’s address 1619 GILMER AVENUE, TALLASSEE, AL, 36078

Signature of
Role Plan administrator
Date 2019-06-25
Name of individual signing JULIE S POSKE

Agent

Name Role Address
HARRIS, ERIC S Agent 1619 GILMER AVENUETALLASSEE, AL 36078

Director

Name Role Address
HARRIS, ERIC S Director 1619 GILMER AVENUETALLASSEE, AL 36078

Incorporator

Name Role Address
HARRIS, ERIC S Incorporator 1619 GILMER AVENUETALLASSEE, AL 36078

Related by officers

HARRIS, ERIC S

Three Lakes Properties, L.L.C.

Related by address

1619 GILMER AVENUETALLASSEE, AL 36078

Three Lakes Properties, L.L.C.

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State

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