| Name: | Jon Bowie, D.M.D., P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 24 May 2001 (23 years ago) |
| Entity Number: | 000-216-639 |
| Register Number: | 000216639 |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | FAIRHOPE, AL |
| Registered Office Street Address: | 23210 US HIGHWAY 98 STE D-1FAIRHOPE, AL 36532 |
| Registered Office Street Address ZIP Code: | 36532 |
| Authorized Capital: | $2,000 |
Activities
RENDER PROFESSIONAL PERIODONTAL/DENTAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891809919 | 2006-08-18 | 2011-02-14 | 4728 AIRPORT BLVD, SUITE A, MOBILE, AL, 366083170, US | 4728 AIRPORT BLVD, SUITE A, MOBILE, AL, 366083170, US | |||||||||||||||||||||||
|
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| Phone | +1 251-343-1794 |
Authorized person
| Name | DR. JON NATHAN BOWIE |
| Role | OWNER/DENTIST |
| Phone | 2513431794 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | 4905 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009985270 |
| State | AL |
| Name | Role |
|---|---|
| BOWIE, JON N | Agent |
| Name | Role |
|---|---|
| BOWIE, JON N | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
