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) |
Entity Number: | 000-352-792 |
Register Number: | 000352792 |
County: | Madison |
Place of Formation: | Madison County |
Registered Office Street Address: | 8097 MADISON BLVD SUITE 107MADISON, AL 35758 |
Registered Office Street Address ZIP Code: | 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 | |||||||||||||||||||||
|
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