| Name: | Marvin M. Hewlett, Jr., D.D.S., P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 02 Jan 2004 (21 years ago) (Companies founded in January 2004) |
| Date of dissolution: | 19 Dec 2019 |
| Entity Number: | 000-232-619 |
| Register Number: | 000232619 |
| ZIP code: | 36037 (Companies in Butler, 36037) |
| County: | Butler |
| Place of Formation: | Butler County |
| Principal Address: | GREENVILLE, AL |
| Registered Office Street Address: | 402 E COMMERCE STGREENVILLE, AL 36037 |
| Authorized Capital: | 200 NPV |
Activities
DENTAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790895530 | 2006-08-30 | 2016-05-03 | 402 E COMMERCE STREET, GREENVILLE, AL, 36037, US | 402 E COMMERCE STREET, GREENVILLE, AL, 36037, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 334-382-5431 |
| Fax | 3343822492 |
Authorized person
| Name | DR. MARVIN MCCOY HEWLETT JR. |
| Role | DENTIST PRESIDENT |
| Phone | 3343825431 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | 3171 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD AL |
| Number | 515 20247 |
| State | AL |
| Issuer | MEDICAID |
| Number | 529919350 |
| State | AL |
| Name | Role |
|---|---|
| HEWLETT, MARVIN M JR | Agent |
| Name | Role |
|---|---|
| HEWLETT, MARVIN M JR | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
