| Name: | Galloway Dental Implants and Periodontics, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 04 Jan 1993 (32 years ago) (Companies founded in January 1993) |
| Entity Number: | 000-153-845 |
| Register Number: | 000153845 |
| Historical Names: |
LEWIS G. HUMPHREYS, JR. DMD, MS, P.C.
|
| ZIP code: | 36303 (Companies in Houston, 36303) |
| County: | Houston |
| Place of Formation: | Houston County |
| Registered Office Street Address: | 102 MEDICAL DRIVEDOTHAN, AL 36303 |
| Authorized Capital: | $100 |
Activities
DENTISTRY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053823005 | 2017-10-31 | 2021-09-29 | 102 MEDICAL DR, DOTHAN, AL, 363036902, US | 102 MEDICAL DR, DOTHAN, AL, 363036902, US | |||||||||||||||||||||||
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| Phone | +1 334-792-7888 |
| Fax | 3347928717 |
Authorized person
| Name | JASMINE M. RODRIGUEZ |
| Role | ADMIN ASST. |
| Phone | 3347927888 |
Taxonomy
| Taxonomy Code | 1223P0300X - Periodontist |
| License Number | 3595 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 1223P0300X - Periodontist |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GALLOWAY DENTAL IMPLANTS AND PERIODONTICS, P.C. 401(K) PROFIT SHARING PLAN | 2023 | 631082398 | 2024-06-25 | GALLOWAY DENTAL IMPLANTS AND PERIODONTICS, P.C. | 15 | |||||||||||||
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| GALLOWAY DENTAL IMPLANTS AND PERIODONTICS, P.C. 401(K) PROFIT SHARING PLAN | 2022 | 631082398 | 2023-09-15 | GALLOWAY DENTAL IMPLANTS AND PERIODONTICS, P.C. | 15 | |||||||||||||
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| GALLOWAY DENTAL IMPLANTS AND PERIODONTICS, P.C. 401(K) PROFIT SHARING PLAN | 2021 | 631082398 | 2022-09-12 | GALLOWAY DENTAL IMPLANTS AND PERIODONTICS, P.C. | 14 | |||||||||||||
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| Name | Role |
|---|---|
| GALLOWAY, PATRICK B | Agent |
| Name | Role | Address |
|---|---|---|
| HUMPHREYS, LEWIS G JR | Incorporator | 102 MEDICAL DRIVEDOTHAN, AL 36303 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2021-03-04 | Name Change | LEWIS G. HUMPHREYS, JR. DMD, MS, P.C. | Galloway Dental Implants and Periodontics, P.C. |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
