Birmingham Orthodontics, PC

Contacts

Phone	+1 205-733-2022
Fax	2057339671

Authorized person

Name	MR. BRIAN MCCARTHY
Role	CEO
Phone	2057332022

Taxonomy

Taxonomy Code	1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
License Number	3871
State	AL
Is Primary	Yes

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2013-01-01
Business code	621210
Sponsor’s telephone number	2052163927
Plan sponsor’s address	5391 MAGNOLIA TRACE, HOOVER, AL, 35244

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2013-01-01
Business code	621210
Sponsor’s telephone number	2052163927
Plan sponsor’s address	5391 MAGNOLIA TRACE, HOOVER, AL, 35244

Signature of

Role	Plan administrator
Date	2022-07-21
Name of individual signing	BILLIE DUPREE

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2013-01-01
Business code	621210
Sponsor’s telephone number	2054530891
Plan sponsor’s address	5391 MAGNOLIA TRACE, HOOVER, AL, 35244

Signature of

Role	Plan administrator
Date	2021-08-29
Name of individual signing	CAREYBETH RIVERS

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2013-01-01
Business code	621210
Sponsor’s telephone number	2054530891
Plan sponsor’s address	3825 LORNA RD, SUITE 248, HOOVER, AL, 35244

Signature of

Role	Plan administrator
Date	2020-09-29
Name of individual signing	CAREYBETH RIVERS

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2013-01-01
Business code	621210
Sponsor’s telephone number	2057332022
Plan sponsor’s address	3825 LORNA RD, SUITE 248, HOOVER, AL, 35244

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2013-01-01
Business code	621210
Sponsor’s telephone number	2057332022
Plan sponsor’s address	3825 LORNA RD, SUITE 248, HOOVER, AL, 35244

Signature of

Role	Plan administrator
Date	2018-06-11
Name of individual signing	CAREYBETH RIVERS

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2013-01-01
Business code	621210
Sponsor’s telephone number	2057332022
Plan sponsor’s address	3825 LORNA RD, SUITE 248, HOOVER, AL, 35244

Signature of

Role	Plan administrator
Date	2017-05-23
Name of individual signing	CAREYBETH RIVERS

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2013-01-01
Business code	621210
Sponsor’s telephone number	2057332022
Plan sponsor’s address	3825 LORNA RD, SUITE 248, HOOVER, AL, 35244

Signature of

Role	Plan administrator
Date	2016-04-20
Name of individual signing	CAREYBETH RIVERS

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2013-01-01
Business code	621210
Sponsor’s telephone number	2057332022
Plan sponsor’s address	3825 LOMA RD, SUITE 248, HOOVER, AL, 35244

Signature of

Role	Plan administrator
Date	2015-05-15
Name of individual signing	MICHAEL F. MCCARTHY, DMD