| Name: | Hartselle Family Dentistry LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 15 Oct 2015 (9 years ago) (Companies founded in October 2015) |
| Entity Number: | 000-347-123 |
| Register Number: | 000347123 |
| ZIP code: | 35640 (Companies in Morgan, 35640) |
| County: | Morgan |
| Place of Formation: | Morgan County |
| Registered Office Street Address: | 1511 HIGHWAY 31 SWHARTSELLE, AL 35640 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588112007 | 2016-09-13 | 2016-09-13 | 1511 HIGHWAY 31 SW, SUITE B, HARTSELLE, AL, 356402818, US | 1511 HIGHWAY 31 SW, SUITE B, HARTSELLE, AL, 356402818, US | |||||||||||||||||||||||||
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| Phone | +1 256-773-0800 |
Authorized person
| Name | ASHLEY LYNN HOLLADAY |
| Role | OWNER/DENTIST |
| Phone | 2567730800 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 5958 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 5773 |
| State | AL |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HARTSELLE FAMILY DENTISTRY 401(K) PLAN | 2023 | 475485867 | 2024-09-09 | HARTSELLE FAMILY DENTISTRY, LLC | 14 | |||||||||||||||||||||
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| HARTSELLE FAMILY DENTISTRY 401(K) PLAN | 2022 | 475485867 | 2023-10-11 | HARTSELLE FAMILY DENTISTRY, LLC | 11 | |||||||||||||||||||||
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| HARTSELLE FAMILY DENTISTRY 401(K) PLAN | 2021 | 475485867 | 2022-10-13 | HARTSELLE FAMILY DENTISTRY, LLC | 8 | |||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2022-10-13 |
| Name of individual signing | MAGGIE MCKELVEY |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2567730800 |
| Plan sponsor’s address | 1511 HWY 31 S, SUITE B, HARTSELLE, AL, 35640 |
Signature of
| Role | Plan administrator |
| Date | 2021-07-26 |
| Name of individual signing | ASHLEY HOLLADAY |
| Name | Role |
|---|---|
| HOLLADAY, ASHLEY L | Agent |
| Name | Role | Address |
|---|---|---|
| MAYHEW, BRADLEY C | Organizer | 1819 FIFTH AVE N STE 1000BIRMINGHAM, AL 35203 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
