| Name: | AUTAUGA STATION DENTAL, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 11 Jan 2013 (12 years ago) |
| Entity Number: | 000-275-789 |
| Register Number: | 000275789 |
| County: | Autauga |
| Place of Formation: | Autauga County |
| Registered Office Street Address: | 1803 STATION DRIVE, SUITE APRATTVILLE, AL 36066 |
| Registered Office Street Address ZIP Code: | 36066 |
| Authorized Capital: | 500 @ $1.00 PV |
Activities
DENTISTRY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235471426 | 2013-03-26 | 2013-03-26 | 1803 STATION DR, SUITE A, PRATTVILLE, AL, 360665668, US | 1803 STATION DR, SUITE A, PRATTVILLE, AL, 360665668, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 334-361-9880 |
| Fax | 3343619876 |
Authorized person
| Name | DR. BROCK C MILLER |
| Role | DENTIST, OWNER |
| Phone | 3343619880 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 4949 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MILLER, BROCK C | Director | 1803 STATION DRIVE, SUITE APRATTVILLE, AL 36066 |
| Name | Role | Address |
|---|---|---|
| MILLER, BROCK C | Agent | 1803 STATION DRIVE, SUITE APRATTVILLE, AL 36066 |
| Name | Role | Address |
|---|---|---|
| MILLER, BROCK C | Incorporator | 1803 STATION DRIVE, SUITE APRATTVILLE, AL 36066 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
