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Midfield Dental Center Associates, P.C.

Details

Name: Midfield Dental Center Associates, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 29 Dec 1993 (31 years ago) (Companies founded in December 1993)
Entity Number: 000-160-920
Register Number: 000160920
ZIP code: 35228 (Companies in Jefferson, 35228)
County: Jefferson
Place of Formation: Jefferson County
Principal Address: MIDFIELD, AL
Registered Office Street Address: 114 EAST BROOKWOOD ROADMIDFIELD, AL 35228
Authorized Capital: $1,000
Paid Share Capital: $1,000

Activities PRACTICE OF DENTISTRY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1558436485 2006-11-24 2020-08-22 114 E BROOKWOOD ROAD, MIDFIELD, AL, 35228, US 114 E BROOKWOOD ROAD, MIDFIELD, AL, 35228, US

Contacts

Phone +1 205-923-6828

Authorized person

Name DR. WILLIAM JEFFERSON GRAVES
Role PRESIDENT
Phone 2059236828

Taxonomy

Taxonomy Code 122300000X - Dentist
License Number 3419
State AL
Is Primary No
Taxonomy Code 1223P0300X - Periodontist
License Number 2563
State AL
Is Primary No
Taxonomy Code 1223S0112X - Oral and Maxillofacial Surgery (Dentist)
License Number 3460
State AL
Is Primary No

Other Provider Identifiers

Issuer UNITED CONCORDIA
Number 993983
State PA

Agent

Name Role
HUGHES, JAMES R Agent

Incorporator

Name Role
HUGHES, JAMES R Incorporator
GRAVES, WILLIAM JEFFERSON Incorporator
JACOBS, WILLIAM PARKS Incorporator
CAMPBELL, WILLIAM L Incorporator

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State