| Name: | Dental Concepts, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 17 Mar 2005 (20 years ago) |
| Entity Number: | 000-461-827 |
| Register Number: | 000461827 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 901 EAST SOUTH BLVDMONTGOMERY, AL 36116 |
| Registered Office Street Address ZIP Code: | 36116 |
Activities
RENDERING PROFESSIONAL DENTAL SERVICES
| 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 | |||||||||||||||||||||||||
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| 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 |
| Name | Role |
|---|---|
| CAWLEY, DAVID | Agent |
| Name | Role |
|---|---|
| CAWLEY, DAVID | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
