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Florence Oral & Maxillofacial Surgery LLC

Details

Name: Florence Oral & Maxillofacial Surgery LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 10 Dec 2008 (16 years ago) (Companies founded in December 2008)
Entity Number: 000-427-976
Register Number: 000427976
ZIP code: 36104 (Companies in Montgomery, 36104)
County: Montgomery
Place of Formation: Montgomery County
Principal Address: MONTGOMERY, AL
Registered Office Street Address: 2 NORTH JACKSON STREET STE 605MONTGOMERY, AL 36104

Activities PROFESSIONAL DENTISTRY SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1134359664 2009-07-17 2009-07-17 154 TITAN DRIVE, FLORENCE, AL, 35630, US 154 TITAN DRIVE, FLORENCE, AL, 35630, US

Contacts
Phone +1 256-712-5096
Fax 2567125097

Authorized person
Name DR. DANIEL LEE MORRIS
Role PHYSICIAN
Phone 2567125096

Taxonomy
Taxonomy Code 1223S0112X - Oral and Maxillofacial Surgery (Dentist)
License Number 4975
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 401(K) PROFIT SHARING PLAN 2020 263908059 2021-04-22 FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Plan sponsor’s address 154 TITAN DR., FLORENCE, AL, 35630

Plan administrator’s name and address
Administrator’s EIN 263908059
Plan administrator’s name FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC
Plan administrator’s address 154 TITAN DR., FLORENCE, AL, 35630
Administrator’s telephone number 2567125096
FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 401(K) PROFIT SHARING PLAN 2019 263908059 2020-05-05 FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Plan sponsor’s address 154 TITAN DR., FLORENCE, AL, 35630

Plan administrator’s name and address
Administrator’s EIN 263908059
Plan administrator’s name FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC
Plan administrator’s address 154 TITAN DR., FLORENCE, AL, 35630
Administrator’s telephone number 2567125096
FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 401(K) PROFIT SHARING PLAN 2018 263908059 2019-10-03 FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Plan sponsor’s address 154 TITAN DR., FLORENCE, AL, 35630

Plan administrator’s name and address
Administrator’s EIN 263908059
Plan administrator’s name FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC
Plan administrator’s address 154 TITAN DR., FLORENCE, AL, 35630
Administrator’s telephone number 2567125096
FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 401(K) PROFIT SHARING PLAN 2017 263908059 2018-06-14 FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Plan sponsor’s address 154 TITAN DR., FLORENCE, AL, 35630

Plan administrator’s name and address
Administrator’s EIN 263908059
Plan administrator’s name FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC
Plan administrator’s address 154 TITAN DR., FLORENCE, AL, 35630
Administrator’s telephone number 2567125096
FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 401(K) PROFIT SHARING PLAN 2016 263908059 2017-11-07 FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 2567125096
Plan sponsor’s address 143 KENSINGTON DRIVE, FLORENCE, AL, 356331577

Plan administrator’s name and address
Administrator’s EIN 263908059
Plan administrator’s name FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC
Plan administrator’s address 143 KENSINGTON DRIVE, FLORENCE, AL, 356331577
Administrator’s telephone number 2567125096
FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 401(K) PROFIT SHARING PLAN 2015 263908059 2016-07-08 FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 2567125096
Plan sponsor’s address 143 KENSINGTON DRIVE, FLORENCE, AL, 356331577

Plan administrator’s name and address
Administrator’s EIN 263908059
Plan administrator’s name FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC
Plan administrator’s address 143 KENSINGTON DRIVE, FLORENCE, AL, 356331577
Administrator’s telephone number 2567125096
FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 401(K) PROFIT SHARING PLAN 2014 263908059 2015-10-14 FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 2567125096
Plan sponsor’s address 143 KENSINGTON DRIVE, FLORENCE, AL, 356331577

Plan administrator’s name and address
Administrator’s EIN 263908059
Plan administrator’s name FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC
Plan administrator’s address 143 KENSINGTON DRIVE, FLORENCE, AL, 356331577
Administrator’s telephone number 2567125096

Signature of
Role Plan administrator
Date 2015-10-14
Name of individual signing DANIEL LEE MORRIS
FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 401(K) PROFIT SHARING PLAN 2013 263908059 2014-09-30 FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 2567125096
Plan sponsor’s address 143 KENSINGTON DRIVE, FLORENCE, AL, 356331577

Plan administrator’s name and address
Administrator’s EIN 263908059
Plan administrator’s name FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC
Plan administrator’s address 143 KENSINGTON DRIVE, FLORENCE, AL, 356331577
Administrator’s telephone number 2567125096

Signature of
Role Plan administrator
Date 2014-09-30
Name of individual signing DANIEL LEE MORRIS
FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 401(K) PROFIT SHARING PLAN 2012 263908059 2013-10-15 FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 2567125096
Plan sponsor’s address 143 KENSINGTON DRIVE, FLORENCE, AL, 356331577

Plan administrator’s name and address
Administrator’s EIN 263908059
Plan administrator’s name FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC
Plan administrator’s address 143 KENSINGTON DRIVE, FLORENCE, AL, 356331577
Administrator’s telephone number 2567125096

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing DANIEL LEE MORRIS
FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 401(K) PROFIT SHARING PLAN 2011 263908059 2012-08-28 FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 2567125096
Plan sponsor’s address 143 KENSINGTON DRIVE, FLORENCE, AL, 356331577

Plan administrator’s name and address
Administrator’s EIN 263908059
Plan administrator’s name FLORENCE ORAL & MAXILLOFACIAL SURGERY, LLC
Plan administrator’s address 143 KENSINGTON DRIVE, FLORENCE, AL, 356331577
Administrator’s telephone number 2567125096

Signature of
Role Plan administrator
Date 2012-08-28
Name of individual signing DANIEL LEE MORRIS

Agent

Name Role
CAPITOL CORPORATE SERVICES INC Agent

Member

Name Role
MORRIS, D LEE Member
GOLDMAN, MERTON B Member

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CAPITOL CORPORATE SERVICES INC

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2 NORTH JACKSON STREET STE 605MONTGOMERY, AL 36104

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Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State

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