| Name: | Shelton Beach Dental Center Inc |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 18 Sep 2013 (11 years ago) |
| Entity Number: | 000-287-982 |
| Register Number: | 000287982 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | 623 SARALAND BLVD SSARALAND, AL 36571 |
| Principal Address ZIP Code: | 36571 |
| Principal Mailing Address: | PO BOX 11474CHICKASAW, AL 36671 |
| Principal Mailing Address ZIP Code: | 36671 |
| Authorized Capital: | 1000 @ $1.00 PV |
Activities
OPERATE A DENTAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205250727 | 2014-02-05 | 2014-02-05 | PO BOX 11474, MOBILE, AL, 366710474, US | 623 HIGHWAY 43 S, SUITE A, SARALAND, AL, 365713633, US | |||||||||||||||||||||
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| Phone | +1 251-675-7630 |
| Fax | 2516753637 |
| Fax | 2516757637 |
Authorized person
| Name | DR. WILLIAM R BRUNER |
| Role | DENTIST |
| Phone | 2516756730 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 3152 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BRUNER, WILLIAM R II | Director | 623 SARALAND BLVD SSARALAND, AL 36571 |
| Name | Role | Address |
|---|---|---|
| BRUNER, WILLIAM R II | Agent | 623 SARALAND BLVD SSARALAND, AL 36571 |
| Name | Role | Address |
|---|---|---|
| BRUNER, WILLIAM R II | Incorporator | 623 SARALAND BLVD SSARALAND, AL 36571 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
