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K. Clay Ellis, Jr., DMD, LLC

Details

Name: K. Clay Ellis, Jr., DMD, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 17 Apr 2007 (18 years ago) (Companies founded in April 2007)
Entity Number: 000-493-394
Register Number: 000493394
ZIP code: 35901 (Companies in Etowah, 35901)
County: Etowah
Place of Formation: Etowah County
Principal Address: GADSDEN, AL
Registered Office Street Address: 315 SOUTH FOURTH STGADSDEN, AL 35901

Activities DENTISTRY PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1770229650 2022-05-12 2022-06-14 311 S 5TH ST STE A, GADSDEN, AL, 359014253, US 311 S 5TH ST STE A, GADSDEN, AL, 359014253, US

Contacts

Phone +1 256-543-1285
Fax 2565431719

Authorized person

Name AMANDA GREGORY
Role OFFICE MANAGER
Phone 2565431285

Taxonomy

Taxonomy Code 1223G0001X - General Practice Dentistry
Is Primary Yes

Agent

Name Role Address
ELLIS, K CLAY JR Agent 139 FAIROAKS CIRCLEGADSDEN, AL 35901

Member

Name Role Address
ELLIS, K CLAY JR Member 139 FAIROAKS CIRCLEGADSDEN, AL 35901

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State