| Name: | Johnny M. Griffin, D.D.S., P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 31 Jan 1984 (41 years ago) (Companies founded in January 1984) |
| Entity Number: | 000-096-218 |
| Register Number: | 000096218 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 222 SOUTH RIPLEY STREETMONTGOMERY, AL 36104 |
| Authorized Capital: | $10,000 |
| Paid Share Capital: | $1,000 |
Activities
DENTISTRY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275872426 | 2013-02-07 | 2015-02-17 | 1401 I85 PKWY STE D, MONTGOMERY, AL, 361062833, US | 1401 I85 PKWY STE D, MONTGOMERY, AL, 361062833, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 334-274-9861 |
| Fax | 3342749863 |
Authorized person
| Name | DR. JOHNNY MACK GRIFFIN |
| Role | PRESIDENT |
| Phone | 3342749861 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 3420 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009901290 |
| State | AL |
| Name | Role |
|---|---|
| GRIFFIN, JOHNNY M DR | Agent |
| Name | Role |
|---|---|
| GRIFFIN, JOHNNY M DR | Incorporator |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
