| Name: | Gabriel A. Chamblin, DMD, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 19 Jun 2009 (15 years ago) |
| Entity Number: | 000-435-235 |
| Register Number: | 000435235 |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | FAIRHOPE, AL |
| Registered Office Street Address: | 319 MAGNOLIA AVEFAIRHOPE, AL 36532 |
| Registered Office Street Address ZIP Code: | 36532 |
Activities
GENERAL DENTISTRY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881159440 | 2019-02-07 | 2019-02-07 | 6450 US HIGHWAY 90 STE D, SPANISH FORT, AL, 365279480, US | 6450 US HIGHWAY 90 STE D, SPANISH FORT, AL, 365279480, US | |||||||||||||||||||||
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| Phone | +1 251-626-7675 |
| Fax | 2516268194 |
Authorized person
| Name | DR. GABRIEL ALPHONSE CHAMBLIN V |
| Role | OWNER |
| Phone | 2516267675 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | GENERAL DENTIST |
| Number | 1083705594 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| STONE, BRUCE B | Agent | 319 MAGNOLIA AVEFAIRHOPE, AL 36532 |
| Name | Role |
|---|---|
| CHAMBLIN, GABRIEL A | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
