| Name: | Robert B. Embry, DDS, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 02 Apr 2003 (22 years ago) (Companies founded in April 2003) |
| Entity Number: | 000-228-371 |
| Register Number: | 000228371 |
| ZIP code: | 35630 (Companies in Lauderdale, 35630) |
| County: | Lauderdale |
| Place of Formation: | Lauderdale County |
| Principal Address: | FLORENCE, AL |
| Registered Office Street Address: | 2009 DARBY DRFLORENCE, AL 35630 |
| Authorized Capital: | $1,000 |
Activities
DEAL IN PROPERTY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508957283 | 2006-09-27 | 2014-09-23 | 642 COX CREEK PARKWAY, FLORENCE, AL, 35630, US | 642 COX CREEK PARKWAY, FLORENCE, AL, 35630, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 256-760-5696 |
| Fax | 2567600599 |
Authorized person
| Name | ROBERT B EMBRY |
| Role | OWNER |
| Phone | 2567605696 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | 5158 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 122300000X - Dentist |
| License Number | DS0000007514 |
| State | TN |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009918845 |
| State | AL |
| Name | Role |
|---|---|
| LENTS, ROBIN | Incorporator |
| EMBRY, ROBERT B | Incorporator |
| Name | Role | Address |
|---|---|---|
| NORVELL, CARTER C | Agent | 2009 DARBY DRIVEFLORENCE, AL 35630 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
