| Name: | CYPRESS CREEK DENTAL, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 26 Dec 2012 (12 years ago) |
| Entity Number: | 000-271-588 |
| Register Number: | 000271588 |
| County: | Lauderdale |
| Place of Formation: | Lauderdale County |
| Registered Office Street Address: | 3500 CLOVERDALE ROADFLORENCE, AL 35630 |
| Registered Office Street Address ZIP Code: | 35630 |
Activities
PROVIDING DENTAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861731085 | 2013-02-07 | 2013-02-07 | 3500 CLOVERDALE RD, FLORENCE, AL, 356331302, US | 3500 CLOVERDALE RD, FLORENCE, AL, 356331302, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 256-766-2606 |
| Fax | 2567648502 |
Authorized person
| Name | DR. TIA KENNEDY |
| Role | OWNER |
| Phone | 2567662606 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 5854 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KENNEDY, TIA | Agent | 510 GARGIS LANETUSCUMBIA, AL 35674 |
| Name | Role | Address |
|---|---|---|
| KENNEDY, TIA | Organizer | 510 GARGIS LANETUSCUMBIA, AL 35674 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
