| Name: | Daniel Hudson DMD PC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 22 Jan 2020 (5 years ago) |
| Entity Number: | 000-598-950 |
| Register Number: | 000598950 |
| County: | Crenshaw |
| Place of Formation: | Crenshaw County |
| Principal Address: | 1666 S FOREST AVELUVERNE, AL 36049 |
| Principal Address ZIP Code: | 36049 |
| Authorized Capital: | 100@$NPV |
Activities
ALL LEGAL PURPOSES INCLUDING DENTAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639201007 | 2007-03-12 | 2023-11-27 | 1666 S FOREST AVE, LUVERNE, AL, 360497305, US | 1666 S FOREST AVE, LUVERNE, AL, 360497305, US | |||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||
| Phone | +1 334-335-3697 |
| Fax | 3343354128 |
Authorized person
| Name | DANIEL COWEN HUDSON |
| Role | OWNER |
| Phone | 3343353697 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS OF AL |
| Number | 51506053 |
| State | AL |
| Issuer | UNITED CONCORDIA |
| Number | 920212 |
| Name | Role | Address |
|---|---|---|
| HUDSON, DANIEL | Agent | 1666 S FOREST AVELUVERNE, AL 36049 |
| Name | Role | Address |
|---|---|---|
| HUDSON, DANIEL | Incorporator | 1666 S FOREST AVELUVERNE, AL 36049 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
