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Fairhope Dental Associates, LLC

Details

Name: Fairhope Dental Associates, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 09 Nov 2005 (19 years ago)
Entity Number: 000-471-421
Register Number: 000471421
County: Baldwin
Place of Formation: Baldwin County
Principal Address: FAIRHOPE, AL
Registered Office Street Address: 108 PROFESSIONAL PARK DRFAIRHOPE, AL 36532
Registered Office Street Address ZIP Code: 36532

Activities DENTISTRY PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1043231293 2006-07-22 2020-08-22 108 PROFESSIONAL PARK DR, FAIRHOPE, AL, 365321922, US 108 PROFESSIONAL PARK DR, FAIRHOPE, AL, 365321922, US

Contacts
Phone +1 251-928-0620
Fax 2519281359

Authorized person
Name DR. WILLIAM T WILSON
Role MANAGER
Phone 2519280620

Taxonomy
Taxonomy Code 1223G0001X - General Practice Dentistry
License Number 3466
State AL
Is Primary Yes

Other Provider Identifiers
Issuer UNITED CONCORDIA
Number 1906760
State AL
Issuer BCBS
Number 03142
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAIRHOPE DENTAL ASSOCIATES, LLC 401(K) PLAN 2023 203761186 2024-08-23 FAIRHOPE DENTAL ASSOCIATES, LLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 2519280620
Plan sponsor’s address 108 PROFESSIONAL PARK DR., FAIRHOPE, AL, 36532
FAIRHOPE DENTAL ASSOCIATES, LLC 401(K) PLAN 2022 203761186 2023-08-21 FAIRHOPE DENTAL ASSOCIATES, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 2519280620
Plan sponsor’s address 108 PROFESSIONAL PARK DR., FAIRHOPE, AL, 36532
FAIRHOPE DENTAL ASSOCIATES, LLC 401(K) PLAN 2021 203761186 2022-07-12 FAIRHOPE DENTAL ASSOCIATES, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 2519280620
Plan sponsor’s address 108 PROFESSIONAL PARK DR., FAIRHOPE, AL, 36532
FAIRHOPE DENTAL ASSOCIATES, LLC 401(K) PLAN AND TRUST 2020 203761186 2021-07-21 FAIRHOPE DENTAL ASSOCIATES, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 2519280620
Plan sponsor’s address 108 PROFESSIONAL PARK DR., FAIRHOPE, AL, 36532
FAIRHOPE DENTAL ASSOCIATES, LLC 401(K) PLAN AND TRUST 2019 203761186 2020-03-26 FAIRHOPE DENTAL ASSOCIATES, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 2519280620
Plan sponsor’s address 108 PROFESSIONAL PARK DR., FAIRHOPE, AL, 36532
FAIRHOPE DENTAL ASSOCIATES, LLC 401(K) PLAN AND TRUST 2018 203761186 2019-05-07 FAIRHOPE DENTAL ASSOCIATES, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 2519280620
Plan sponsor’s address 108 PROFESSIONAL PARK DR., FAIRHOPE, AL, 36532
FAIRHOPE DENTAL ASSOCIATES, LLC 401(K) PLAN AND TRUST 2017 203761186 2018-03-21 FAIRHOPE DENTAL ASSOCIATES, LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 2519280620
Plan sponsor’s address 108 PROFESSIONAL PARK DR., FAIRHOPE, AL, 36532
FAIRHOPE DENTAL ASSOCIATES, LLC 401(K) PLAN AND TRUST 2016 203761186 2017-07-03 FAIRHOPE DENTAL ASSOCIATES, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 2519280620
Plan sponsor’s address 108 PROFESSIONAL PARK DR., FAIRHOPE, AL, 36532
FAIRHOPE DENTAL ASSOCIATES, LLC 401(K) PLAN AND TRUST 2015 203761186 2016-04-21 FAIRHOPE DENTAL ASSOCIATES, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 2519280620
Plan sponsor’s address 108 PROFESSIONAL PARK DR., FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2016-04-21
Name of individual signing JOHN GREEN, JR.
Role Employer/plan sponsor
Date 2016-04-21
Name of individual signing JOHN GREEN, JR.
FAIRHOPE DENTAL ASSOCIATES, LLC 401(K) PLAN AND TRUST 2014 203761186 2015-07-13 FAIRHOPE DENTAL ASSOCIATES, LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 2519280620
Plan sponsor’s address 108 PROFESSIONAL PARK DR., FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2015-07-12
Name of individual signing JOHN GREEN, JR.
Role Employer/plan sponsor
Date 2015-07-12
Name of individual signing JOHN GREEN, JR.

Agent

Name Role
WILSON, WILLIAM T Agent

Member

Name Role
WILSON, WILLIAM T Member

Related by officers

WILSON, WILLIAM T

Wilson Properties, LLC

Related by address

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108 PROFESSIONAL PARK DRFAIRHOPE, AL 36532

Wilson Properties, LLC

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State

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