| Name: | Lake Guntersville Dentistry, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 06 Jul 2006 (18 years ago) |
| Entity Number: | 000-481-076 |
| Register Number: | 000481076 |
| County: | Marshall |
| Place of Formation: | Marshall County |
| Registered Office Street Address: | 1621 BLOUNT AVEGUNTERSVILLE, AL 35976 |
| Registered Office Street Address ZIP Code: | 35976 |
| Principal Address: | GUNTERSVILLE, AL |
Activities
PROFESSIONAL DENTAL HEALTHCARE SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902392061 | 2018-07-02 | 2018-07-02 | 1621 BLOUNT AVE, GUNTERSVILLE, AL, 359761839, US | 1621 BLOUNT AVE, GUNTERSVILLE, AL, 359761839, US | |||||||||||||
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| Phone | +1 256-582-5652 |
Authorized person
| Name | DANIA FLOYD |
| Role | OFFICE ADMIN |
| Phone | 2565825652 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAKE GUNTERSVILLE DENTISTRY 401(K) PLAN | 2023 | 205158031 | 2024-10-07 | LAKE GUNTERSVILLE DENTISTRY | 12 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-10-07 |
| Name of individual signing | CARL LARSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-09-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2565825652 |
| Plan sponsor’s address | 1621 BLOUNT AVENUE, GUNTERSVILLE, AL, 35976 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-10 |
| Name of individual signing | CARL LARSON |
| Name | Role | Address |
|---|---|---|
| LARSON, CARL ROBERT | Agent | 1621 BLOUNT AVENUEGUNTERSVILLE, AL 35976 |
| Name | Role | Address |
|---|---|---|
| LARSON, CARL ROBERT | Member | 1621 BLOUNT AVENUEGUNTERSVILLE, AL 35976 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
