| Name: | Paul Gaston Petznick, DMD, FAGD, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 14 Jun 2016 (8 years ago) |
| Entity Number: | 000-364-824 |
| Register Number: | 000364824 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 2541 CANTERBURY ROADMOUNTAIN BROOK, AL 35223 |
| Registered Office Street Address ZIP Code: | 35223 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265970487 | 2017-02-08 | 2017-02-08 | PO BOX 530652, BIRMINGHAM, AL, 352530652, US | 2045 BROOKWOOD MEDICAL CTR DR, SUITE 6, HOMEWOOD, AL, 352096874, US | |||||||||||||||||||
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| Phone | +1 205-326-7444 |
| Fax | 2056371933 |
Authorized person
| Name | DR. PAUL GASTON PETZNICK |
| Role | DENTIST |
| Phone | 2053267444 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | 4316 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| PETZNICK, PAUL G | Agent |
| Name | Role |
|---|---|
| GELLER, MATTHEW S. | Organizer |
Date of last update: 04 Aug 2024
Sources: Alabama Secretary of State
