| Name: | Blake Phillips D.M.D., P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 07 Mar 2019 (6 years ago) |
| Entity Number: | 000-545-702 |
| Register Number: | 000545702 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 1112 NINETEENTH STREET SOUTHBIRMINGHAM, AL 35205 |
| Registered Office Street Address ZIP Code: | 35205 |
| Authorized Capital: | 1000 @ $0.01 PV |
Activities
DENTISTRY & ORAL SURGERY
ANY AND ALL LAWFUL BUSINESS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881236883 | 2019-10-10 | 2019-11-14 | 1112 19TH ST S, BIRMINGHAM, AL, 352054814, US | 1112 19TH ST S, BIRMINGHAM, AL, 352054814, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 205-933-1331 |
Authorized person
| Name | JOSEPH BLAKE PHILLIPS |
| Role | ORAL AND MAXILLOFACIAL SURGEON |
| Phone | 2059331332 |
Taxonomy
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PHILLIPS, BLAKE | Agent | 739 LINWOOD ROADBIRMINGHAM, AL 35222 |
| Name | Role | Address |
|---|---|---|
| PHILLIPS, BLAKE | Director | 739 LINWOOD ROADBIRMINGHAM, AL 35222 |
| Name | Role | Address |
|---|---|---|
| SPARKS, BUTLER | Incorporator | 1819 5TH AVE NBIRMINGHAM, AL 35203 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
