| Name: | Vital Smiles Alabama, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 22 Jun 2007 (17 years ago) |
| Entity Number: | 000-253-180 |
| Register Number: | 000253180 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 1900 CRESTWOOD BLVD STE 211BIRMINGHAM, AL 35210 |
| Registered Office Street Address ZIP Code: | 35210 |
| Authorized Capital: | $1,000 |
Activities
DENTISTRY PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245637859 | 2014-11-25 | 2014-11-25 | 1900 CRESTWOOD BLVD, SUITE 211, IRONDALE, AL, 352102034, US | 111 B Y WILLIAMS SR DR, MIDFIELD, AL, 352282218, US | |||||||||||||||||||||||
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| Phone | +1 205-271-6841 |
| Fax | 2052716836 |
| Phone | +1 205-923-3172 |
| Fax | 2059233926 |
Authorized person
| Name | RONALD PHILIPP |
| Role | ORTHODONTIST |
| Phone | 2052716831 |
Taxonomy
| Taxonomy Code | 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist |
| License Number | 3061 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| JOHNSON, G DAVID JR | Agent |
| Name | Role |
|---|---|
| JOHNSON, G DAVID JR | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
