| Name: | University Orthodontics LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 14 Sep 2017 (7 years ago) |
| Date of dissolution: | 17 Oct 2019 |
| Entity Number: | 000-403-157 |
| Register Number: | 000403157 |
| Historical Names: |
University Orthodontic Services, LLC
|
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | 641 HELEN KELLER BLVDTUSCALOOSA, AL 35404 |
| Registered Office Street Address ZIP Code: | 35404 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104330950 | 2017-11-30 | 2017-11-30 | 641 HELEN KELLER BLVD, TUSCALOOSA, AL, 354042983, US | 641 HELEN KELLER BLVD, TUSCALOOSA, AL, 354042983, US | |||||||||||||||||||
|
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| Phone | +1 205-553-2524 |
| Fax | 2055536617 |
Authorized person
| Name | DR. PETER JASON GOLTZ |
| Role | OWNER/ORTHODONTIST |
| Phone | 2055532524 |
Taxonomy
| Taxonomy Code | 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist |
| License Number | 5557 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| GOLTZ, JASON | Agent |
| Name | Role | Address |
|---|---|---|
| STAGGS, CLAY | Organizer | 701 22ND AVENUE, SUITE 1TUSCALOOSA, AL 35401 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2017-11-28 | Name Change | University Orthodontic Services, LLC | University Orthodontics LLC |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
