| Name: | Northeast Alabama Dental, PC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 03 Sep 2014 (10 years ago) |
| Entity Number: | 000-317-609 |
| Register Number: | 000317609 |
| County: | Etowah |
| Place of Formation: | Etowah County |
| Registered Office Street Address: | 315 SOUTH 4TH STREETGADSDEN, AL 35901 |
| Registered Office Street Address ZIP Code: | 35901 |
| Authorized Capital: | 1000 |
Activities
MEDICAL
DENTAL AND OTHER HEALTH SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548664055 | 2014-10-13 | 2014-10-13 | 106 LEGACY PARK WAY, SPRINGVILLE, AL, 35146, US | 106 LEGACY PARK WAY, SPRINGVILLE, AL, 35146, US | |||||||||||||
|
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| Phone | +1 256-328-6998 |
Authorized person
| Name | BRANT HAYNIE |
| Role | OWNER |
| Phone | 2563286998 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HAYNIE, BRANT D | Agent | 654 VALLEY CUB DRIVEALEXANDRIA, AL 36250 |
| Name | Role | Address |
|---|---|---|
| HAYNIE, BRANT D | Director | 654 VALLEY CUB DRIVEALEXANDRIA, AL 36250 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
