| Name: | Madison Oral Facial Surgery, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 05 Oct 2009 (15 years ago) |
| Entity Number: | 000-439-063 |
| Register Number: | 000439063 |
| County: | Madison |
| Place of Formation: | Jefferson County |
| Principal Address: | MADISON, AL |
| Registered Office Street Address: | 44 HUGHES RD STE 1500MADISON, AL 35758 |
| Registered Office Street Address ZIP Code: | 35758 |
Activities
ORAL/FACIAL SURGICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346576915 | 2009-11-02 | 2009-11-02 | 44 HUGHES RD, SUITE 1500, MADISON, AL, 357582237, US | 44 HUGHES RD, SUITE 1500, MADISON, AL, 357582237, US | |||||||||||||||||
|
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| Phone | +1 256-774-3535 |
Authorized person
| Name | DR. RAKESH SHAH |
| Role | MANAGING MEMBER |
| Phone | 2055725880 |
Taxonomy
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| License Number | 5551 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| SHAH, RAKESH ARVIND | Agent |
| Name | Role |
|---|---|
| SHAH, RAKESH ARVIND | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
