| Name: | TimberLand Dental, PC. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 24 Aug 2010 (14 years ago) (Companies founded in August 2010) |
| Entity Number: | 000-265-079 |
| Register Number: | 000265079 |
| ZIP code: | 36527 (Companies in Baldwin, 36527) |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | SPANISH FORT, AL |
| Registered Office Street Address: | 8241 PINE RUNSPANISH FORT, AL 36527 |
| Authorized Capital: | $1,000 |
Activities
DENTAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801105556 | 2010-09-29 | 2010-09-29 | 301 E 1ST ST, BAY MINETTE, AL, 365074029, US | 301 E 1ST ST, BAY MINETTE, AL, 365074029, US | |||||||||||||||||||||||||||||||
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| Phone | +1 251-580-0979 |
| Fax | 2515800971 |
Authorized person
| Name | DR. HARRY HUGER HOUSTON III |
| Role | PRESIDENT/OWNER |
| Phone | 2515800979 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | 5114 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BC/BS |
| Number | 515-38527 |
| State | AL |
| Issuer | MEDICAID |
| Number | 009931835 |
| State | AL |
| Name | Role |
|---|---|
| HOUSTON, HARRY H | Incorporator |
| Name | Role |
|---|---|
| HOUSTON, HARRY H | Agent |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
