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Daphne Pediatric Dentistry, Inc.

Details

Name: Daphne Pediatric Dentistry, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Dissolved
Date of registration: 06 Jan 2004 (21 years ago) (Companies founded in January 2004)
Date of dissolution: 22 Dec 2022
Entity Number: 000-233-063
Register Number: 000233063
ZIP code: 36526 (Companies in Baldwin, 36526)
County: Baldwin
Place of Formation: Baldwin County
Principal Address: DAPHNE, AL
Registered Office Street Address: 7058 PROFESSIONAL PLDAPHNE, AL 36526
Authorized Capital: $100

Activities DENTISTRY PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1841374899 2006-10-25 2020-08-22 7058 PROFESSIONAL PLACE, DAPHNE, AL, 36526, US 7058 PROFESSIONAL PLACE, DAPHNE, AL, 36526, US

Contacts

Phone +1 251-447-0627
Fax 2514470639

Authorized person

Name HAROLD TODD CHAMBLISS
Role PEDIATRIC DENTIST
Phone 2514470627

Taxonomy

Taxonomy Code 1223P0221X - Pediatric Dentist
License Number 4830
State AL
Is Primary Yes

Agent

Name Role
CAHMBLISS, H TODD Agent

Incorporator

Name Role Address
OLMSTEAD, CRAIG D Incorporator 234 OFFICE PARK DRIVEGULF SHORES, AL 36542

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State