| Name: | Complete Dental North Madison, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Series Limited Liability Company |
| Status: | Exists |
| Date of registration: | 04 Jan 2016 (9 years ago) (Companies founded in January 2016) |
| Entity Number: | 000-352-792 |
| Register Number: | 000352792 |
| ZIP code: | 35758 (Companies in Madison, 35758) |
| County: | Madison |
| Place of Formation: | Madison County |
| Registered Office Street Address: | 8097 MADISON BLVD SUITE 107MADISON, AL 35758 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447619689 | 2016-02-16 | 2016-02-16 | 8141 US 72, SUITE. G, MADISON, AL, 35758, US | 120 W DUBLIN DR, SUITE. 202, MADISON, AL, 357583155, US | |||||||||||||||||||||
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| Phone | +1 256-774-7228 |
| Fax | 2564645763 |
| Phone | +1 256-258-3883 |
Authorized person
| Name | MRS. TERESA J HAAKE |
| Role | BILLING COORDINATOR |
| Phone | 2562583883 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 5311 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BURNEY, L JUSTIN | Organizer | 655 GALLATIN STHUNTSVILLE, AL 35801 |
| Name | Role | Address |
|---|---|---|
| CHAMBLESS, BRANDON | Agent | 120 WEST DUBLIN SUITE 202MADISON, AL 35758 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
