| Name: | DR. MARVIN L. BARRON DENTAL PRACTICE, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 27 Sep 2012 (12 years ago) (Companies founded in September 2012) |
| Entity Number: | 000-267-992 |
| Register Number: | 000267992 |
| ZIP code: | 35986 (Companies in De Kalb, 35986) |
| County: | De Kalb |
| Place of Formation: | DeKalb County |
| Registered Office Mailing Address: | PO BOX 729RAINSVILLE, AL 35986 |
| Registered Office Street Address: | 103 CHURCH STREET NORTHWEST SUITE 1RAINSVILLE, AL 35986 |
Activities
DENTAL CARE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881020097 | 2013-09-19 | 2013-09-19 | PO BOX 729, RAINSVILLE, AL, 359860729, US | 103 CHURCH AVENUE, RAINSVILLE CLINIC, RAINSVILLE, AL, 35986, US | |||||||||||||||||||||||||
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| Phone | +1 256-638-2111 |
| Fax | 2566386205 |
Authorized person
| Name | DR. MARVIN LEE BARRON |
| Role | OWNER |
| Phone | 2566382111 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | 97 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 147337 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| BARRON, MARVIN L SR | Agent | 103 CHURCH STREET NORTHWEST STE 1RAINSVILLE, AL 35986 |
| Name | Role | Address |
|---|---|---|
| BARRON, MARVIN L SR | Organizer | 103 CHURCH STREET NORTHWEST STE 1RAINSVILLE, AL 35986 |
| BARRON, MARVIN L | Organizer | No data |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
