| Name: | Chelsea Family Dentistry, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 07 Jun 2005 (19 years ago) |
| Entity Number: | 000-241-933 |
| Register Number: | 000241933 |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Principal Address: | CHELSEA, AL |
| Registered Office Street Address: | 16233 HIGHWAY 280 STE FCHELSEA, AL 35043 |
| Registered Office Street Address ZIP Code: | 35043 |
| Authorized Capital: | $1,000 |
Activities
PRACTICE OF DENTISTRY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992827885 | 2007-04-04 | 2008-12-17 | 300 JADE PARK,, STE 302, CHELSEA, AL, 35043, US | 300 JADE PARK,, STE 302, CHELSEA, AL, 35043, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 205-678-2096 |
| Fax | 2056782098 |
Authorized person
| Name | DR. L. MICHELLE JONES |
| Role | DMD |
| Phone | 2056782096 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 4851 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 5299311090 |
| State | AL |
| Issuer | UNITED CONCORDIA |
| Number | 348510 |
| State | AL |
| Name | Role |
|---|---|
| JONES, L MICHELLE | Agent |
| Name | Role |
|---|---|
| JONES, L MICHELLE | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
