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) |
Date of dissolution: | 19 Dec 2019 |
Entity Number: | 000-232-619 |
Register Number: | 000232619 |
County: | Butler |
Place of Formation: | Butler County |
Principal Address: | GREENVILLE, AL |
Registered Office Street Address: | 402 E COMMERCE STGREENVILLE, AL 36037 |
Registered Office Street Address ZIP Code: | 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 | |||||||||||||||||||||||||||||||
|
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