| Name: | Locust Fork Family Dentistry, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 21 May 2009 (15 years ago) |
| Entity Number: | 000-261-015 |
| Register Number: | 000261015 |
| County: | Blount |
| Place of Formation: | Blount County |
| Principal Address: | CLEVELAND, AL |
| Registered Office Street Address: | 15160 ST HWY 160CLEVELAND, AL 35049 |
| Registered Office Street Address ZIP Code: | 35049 |
| Authorized Capital: | $1,000 |
Activities
DENTISTRY PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386158293 | 2017-11-30 | 2017-11-30 | 29984 STATE HIGHWAY 79 STE 300, LOCUST FORK, AL, 350975877, US | 29984 STATE HIGHWAY 79 STE 300, LOCUST FORK, AL, 350975877, US | |||||||||||||||||||
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| Phone | +1 205-681-3050 |
| Fax | 8448156428 |
Authorized person
| Name | RACHEL G OSBORNE |
| Role | OWNER/OPERATOR |
| Phone | 2056813050 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 5624 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JOHNSON, RACHEL | Agent | 289 GRAVEL HILL RDSTATE LINE, MS 39362 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, RACHEL | Incorporator | 289 GRAVEL HILL RDSTATE LINE, MS 39362 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
