| Name: | Gardendale Family Dentistry, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 15 Dec 2017 (7 years ago) |
| Entity Number: | 000-450-362 |
| Register Number: | 000450362 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 205 CALDWELL DRIVEWARRIOR, AL 35180 |
| Registered Office Street Address ZIP Code: | 35180 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437666120 | 2018-01-04 | 2018-01-04 | 2619 DECATUR HWY, FULTONDALE, AL, 350681723, US | 2619 DECATUR HWY, FULTONDALE, AL, 350681723, US | |||||||||||||||||||
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| Phone | +1 205-631-7301 |
| Fax | 2058417496 |
Authorized person
| Name | LASHEA DODSON |
| Role | INSURANCE DEPARTMENT MANAGER |
| Phone | 2056473181 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 5416 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| GRAHAM, ADAM | Agent |
| Name | Role | Address |
|---|---|---|
| THOMPSON, CHRIS | Organizer | 1901 SIXTH AVE N STE 1400BIRMINGHAM, AL 35203 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
