| Name: | MOBILE DENTAL CARE, PC. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 21 Oct 2013 (11 years ago) (Companies founded in October 2013) |
| Date of dissolution: | 08 Jan 2016 |
| Entity Number: | 000-289-777 |
| Register Number: | 000289777 |
| ZIP code: | 36609 (Companies in Mobile, 36609) |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Registered Office Street Address: | 855 QUAL HOLLOW ROADMOBILE, AL 36695 |
| Principal Address: | 515 AZALEA ROADMOBILE, AL 36609 |
| Principal Mailing Address: | 855 QUAIL HOLLOW ROADMOBILE, AL 36695 |
| Authorized Capital: | 100 @ $50PV |
Activities
DENTAL OFFICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255775979 | 2013-04-24 | 2013-04-24 | 515 AZALEA RD, MOBILE, AL, 366091501, US | 515 AZALEA RD, MOBILE, AL, 366091501, US | |||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 251-648-8936 |
| Fax | 2519644012 |
Authorized person
| Name | DR. UYEN N HOANG |
| Role | DENTIST |
| Phone | 2516488936 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | LNO-5776 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | LNO-5776 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 124007 |
| State | AL |
| Issuer | MEDICAID |
| Number | 124009 |
| State | AL |
| Issuer | STATE LICENSE |
| Number | LNO-5776 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| HOANG, UYEN | Agent | 515 AZALEA ROADMOBILE, AL 36609 |
| Name | Role | Address |
|---|---|---|
| HOANG, UYEN | Director | 515 AZALEA ROADMOBILE, AL 36609 |
| Name | Role | Address |
|---|---|---|
| HOANG, UYEN | Incorporator | 515 AZALEA ROADMOBILE, AL 36609 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
