| Name: | Fairhope Modern Dental, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 14 Feb 2018 (7 years ago) |
| Date of dissolution: | 24 Jun 2023 |
| Entity Number: | 000-510-389 |
| Register Number: | 000510389 |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | 106 LOTTIE LANEFAIRHOPE, AL 36532 |
| Principal Address ZIP Code: | 36532 |
| Authorized Capital: | 1M NPV |
Activities
DENTAL PRACTICE/ORAL SURGERY/PERIODONITA/ORTHODONTIA/RELATED
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053811067 | 2018-02-16 | 2018-02-16 | 106 LOTTIE LN, FAIRHOPE, AL, 365322995, US | 106 LOTTIE LN, FAIRHOPE, AL, 365322995, US | |||||||||||||||||
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| Phone | +1 251-928-0400 |
Authorized person
| Name | DR. ANDREW JOSEPH KNIGHT |
| Role | PRESIDENT |
| Phone | 2568280793 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | 5616 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KNIGHT, ANDREW | Director | 106 HAVENWOOD CIRDAPHNE, AL 36526 |
| Name | Role | Address |
|---|---|---|
| KNIGHT, ANDREW | Agent | 106 HAVENWOOD CIRDAPHNE, AL 36526 |
| Name | Role | Address |
|---|---|---|
| BAGGETTE, JOHN R JR | Incorporator | 2101 W CLINTON AVENUE SUITE 102HUNTSVILLE, AL 35805 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
