| Name: | Pediatric Dental Associates of Cahaba Heights, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 19 Apr 2018 (7 years ago) |
| Date of dissolution: | 05 Apr 2021 |
| Entity Number: | 000-516-227 |
| Register Number: | 000516227 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 2090 COLUMBIANA ROAD, SUITE 2000BIRMINGHAM, AL 35216 |
| Registered Office Street Address ZIP Code: | 35216 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639668486 | 2018-05-08 | 2018-05-08 | 4213 DOLLY RIDGE RD, VESTAVIA, AL, 352435703, US | 4213 DOLLY RIDGE RD, VESTAVIA, AL, 352435703, US | |||||||||||||||||
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| Phone | +1 205-490-6850 |
Authorized person
| Name | DR. RICHARD CHAMBLISS |
| Role | OWNER |
| Phone | 2054530314 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| License Number | 5181 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HASTY, WILLIAM D JR | Agent | 2090 COLUMBIANA ROAD STE 2000BIRMINGHAM, AL 35216 |
| Name | Role | Address |
|---|---|---|
| HASTY, WILLIAM D JR | Organizer | 2090 COLUMBIANA ROAD STE 2000BIRMINGHAM, AL 35216 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
