| Name: | OTM Pediatric Dentistry, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 07 Jan 2020 (5 years ago) |
| Date of dissolution: | 13 Dec 2022 |
| Entity Number: | 000-597-717 |
| Register Number: | 000597717 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 2401 DOLLY RIDGE RDVESTAVIA HILLS, AL 35243 |
| Registered Office Street Address ZIP Code: | 35243 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801423280 | 2020-03-25 | 2020-03-25 | 2401 DOLLY RIDGE RD, VESTAVIA, AL, 352434609, US | 521 HIGHWAY 31 S STE 125, VESTAVIA HILLS, AL, 352161877, US | |||||||||||||||||||
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| Phone | +1 205-983-8980 |
| Fax | 2059838982 |
| Phone | +1 205-822-4284 |
| Fax | 2058224285 |
Authorized person
| Name | DR. FLYNT GILBERT PURVIS |
| Role | PRESIDENT |
| Phone | 2059838980 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PURVIS, FLYNT G | Agent | 3848 TIMBERLINE WAYBIRMINGHAM, AL 35243 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
