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Dental Concepts, LLC

Details

Name: Dental Concepts, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 17 Mar 2005 (20 years ago) (Companies founded in March 2005)
Entity Number: 000-461-827
Register Number: 000461827
ZIP code: 36116 (Companies in Montgomery, 36116)
County: Montgomery
Place of Formation: Montgomery County
Principal Address: MONTGOMERY, AL
Registered Office Street Address: 901 EAST SOUTH BLVDMONTGOMERY, AL 36116

Activities RENDERING PROFESSIONAL DENTAL SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1356851323 2017-10-04 2017-10-04 4146 CARMICHAEL RD STE A, MONTGOMERY, AL, 361063634, US 4146 CARMICHAEL RD STE A, MONTGOMERY, AL, 361063634, US

Contacts

Phone +1 334-286-0896
Fax 3342868046

Authorized person

Name DAVID MANUEL CAWLEY
Role DENTIST
Phone 3342860896

Taxonomy

Taxonomy Code 261QD0000X - Dental Clinic/Center
License Number 4147
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 1457438285
State AL

Agent

Name Role
CAWLEY, DAVID Agent

Member

Name Role
CAWLEY, DAVID Member

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State