Alexander City Dental Care, PLLC

Contacts

Phone	+1 256-234-5003

Authorized person

Name	TERRY MCLAIN
Role	OFFICE CONSULTANT
Phone	3345248984

Taxonomy

Taxonomy Code	1223G0001X - General Practice Dentistry
License Number	D4800
State	AL
Is Primary	Yes

Other Provider Identifiers

Issuer	NPI FOR LEONARD DENTAL, PC
Number	1164617536
Issuer	NPI FOR JAMES BRANDON LEONARD, DMD
Number	1891803342

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2022-01-01
Business code	111100
Sponsor’s telephone number	3344445057
Plan sponsor’s address	125 ALISON DR STE 9, ALEXANDER CITY, AL, 350104410

Signature of

Role	Plan administrator
Date	2024-07-08
Name of individual signing	KATY LEONARD

Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Business code	111100
Sponsor’s telephone number	3344445057
Plan sponsor’s address	125 ALISON DR STE 9, ALEXANDER CITY, AL, 350104410

Signature of

Role	Plan administrator
Date	2023-06-28
Name of individual signing	KATY LEONARD

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Business code	111100
Sponsor’s telephone number	3344445057
Plan sponsor’s address	125 ALISON DR STE 9, ALEXANDER CITY, AL, 350104410

Signature of

Role	Plan administrator
Date	2023-07-17
Name of individual signing	KATY LEONARD

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	3344445057
Plan sponsor’s address	125 ALISON DR. SUITE 9,, ALEXANDER CITY, AL, 35010

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	3344445057
Plan sponsor’s address	125 ALISON DR. SUITE 9,, ALEXANDER CITY, AL, 35010

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	3344445057
Plan sponsor’s address	125 ALISON DR. SUITE 9,, ALEXANDER CITY, AL, 35010

Signature of

Role	Plan administrator
Date	2020-04-13
Name of individual signing	KATY LEONARD
Role	Employer/plan sponsor
Date	2020-04-13
Name of individual signing	KATY LEONARD

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	3344445067
Plan sponsor’s address	125 ALISON DR. SUITE 9,, ALEXANDER CITY, AL, 35010

Signature of

Role	Plan administrator
Date	2019-06-13
Name of individual signing	KATY LEONARD
Role	Employer/plan sponsor
Date	2019-06-13
Name of individual signing	KATY LEONARD