| Name: | Willis Family Dentistry LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 18 Jul 2018 (6 years ago) |
| Entity Number: | 000-524-993 |
| Register Number: | 000524993 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Registered Office Street Address: | 3708 CALDERWOOD DRIVEMOBILE, AL 36608 |
| Registered Office Street Address ZIP Code: | 36608 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558845560 | 2018-09-17 | 2018-09-17 | 6217 COTTAGE HILL RD, MOBILE, AL, 366093109, US | 6217 COTTAGE HILL RD, MOBILE, AL, 366093109, US | |||||||||||||||||
|
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| Phone | +1 251-660-1514 |
Authorized person
| Name | DR. JOSEPH WILLIS |
| Role | DENTIST |
| Phone | 2516601514 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 15435837 |
| Name | Role |
|---|---|
| WILLIS, JOSEPH T | Agent |
| Name | Role | Address |
|---|---|---|
| TAIT, CHARLES E | Organizer | 11 NORTH WATER STREET, SUITE 22200MOBILE, AL 36602-5537 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
