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Shoals Pediatric Dentistry, P.C.

Details

Name: Shoals Pediatric Dentistry, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 02 Apr 2003 (22 years ago)
Entity Number: 000-228-370
Register Number: 000228370
County: Lauderdale
Place of Formation: Lauderdale County
Principal Address: FLORENCE, AL
Registered Office Street Address: 2009 DARBY DRFLORENCE, AL 35630
Registered Office Street Address ZIP Code: 35630
Authorized Capital: $1,000

Activities DEAL IN PROPERTY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1851488233 2006-10-06 2020-08-22 640 COX CREEK PKWY, FLORENCE, AL, 356301105, US 640 COX CREEK PKWY, FLORENCE, AL, 356301105, US

Contacts

Phone +1 256-760-5660
Fax 2567604681

Authorized person

Name DR. ROBIN E. LENTS
Role PRESIDENT/PEDIATRIC DENTIST
Phone 2567605660

Taxonomy

Taxonomy Code 1223P0221X - Pediatric Dentist
License Number 5111
State AL
Is Primary Yes

Agent

Name Role Address
NORVELL, CARTER C Agent 2009 DARBY DRIVEFLORENCE, AL 35630

Incorporator

Name Role
EMBRY, ROBERT B Incorporator
LENTS, ROBIN Incorporator

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State