| Name: | Banks Family Dentistry, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 21 Jan 2003 (22 years ago) (Companies founded in January 2003) |
| Entity Number: | 000-227-034 |
| Register Number: | 000227034 |
| ZIP code: | 35565 (Companies in Winston, 35565) |
| County: | Winston |
| Place of Formation: | Winston County |
| Principal Address: | HALEYVILLE, AL |
| Registered Office Street Address: | 42451 HWY 195HALEYVILLE, AL 35565 |
| Authorized Capital: | $1,000 |
Activities
FAMILY DENTAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164972923 | 2016-10-05 | 2016-10-05 | 2095 20TH AVE, HALEYVILLE, AL, 355652136, US | 2095 20TH AVE, HALEYVILLE, AL, 355652136, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 205-486-8601 |
Authorized person
| Name | CHARLES H BANKS JR. |
| Role | PRESIDENT |
| Phone | 2054868601 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | 4826 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 122300000X - Dentist |
| License Number | 6238 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1538459458 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| BANKS, CHARLES H JR | Agent | 1285 14TH AVENUEHALEYVILLE, AL 35565 |
| Name | Role |
|---|---|
| MASDON, SAMUEL A | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
