| Name: | Dental Wellness Center of Birmingham LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 06 May 2016 (9 years ago) |
| Entity Number: | 000-361-996 |
| Register Number: | 000361996 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 3840 BENT RIVER ROADBIRMINGHAM, AL 35216 |
| Registered Office Street Address ZIP Code: | 35216 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437602281 | 2016-07-28 | 2016-07-28 | 2001 PARK PL, SUITE 835, BIRMINGHAM, AL, 352032735, US | 2001 PARK PL, SUITE 835, BIRMINGHAM, AL, 352032735, US | |||||||||||||||||||
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| Phone | +1 205-323-0454 |
| Fax | 2053230458 |
Authorized person
| Name | DR. CHARLESIA MCLIN |
| Role | DENTIST |
| Phone | 2053230454 |
Taxonomy
| Taxonomy Code | 302F00000X - Exclusive Provider Organization |
| License Number | 6130 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| MCLIN, CHARLESIA | Organizer |
| Name | Role |
|---|---|
| MCLIN, CHARLESIA | Agent |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
