| Name: | Magic City Dentistry, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 24 Oct 2017 (7 years ago) |
| Entity Number: | 000-406-685 |
| Register Number: | 000406685 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 2816 COLUMBIANA ROADVESTAVIA, AL 35216 |
| Registered Office Street Address ZIP Code: | 35216 |
Activities
PERFORM DENTAL SERVICES TO THE PUBLIC
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790275840 | 2018-05-15 | 2018-05-15 | 2816 COLUMBIANA RD, VESTAVIA HILLS, AL, 352162518, US | 2117 1ST AVE N, BIRMINGHAM, AL, 352034201, US | |||||||||||||||||||
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| Phone | +1 205-823-3223 |
| Phone | +1 205-238-6800 |
Authorized person
| Name | AINSLEE BOSWELL |
| Role | ADMINISTRATIVE ASSISTANT |
| Phone | 2058233223 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | 4659 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| PRUITT, ROBIN JR | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
