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Azalea City Dental, L.L.C.

Details

Name: Azalea City Dental, L.L.C.
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 30 Dec 1994 (30 years ago) (Companies founded in December 1994)
Entity Number: 000-651-268
Register Number: 000651268
ZIP code: 36611 (Companies in Mobile, 36611)
County: Mobile
Place of Formation: Mobile County
Principal Address: 474 N CRAFT HWYCHICKASAW, AL 36611

Activities PRACTICE OF DENTISTRY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1275806770 2012-02-14 2012-02-14 6593 SPANISH FORT BLVD, SPANISH FORT, AL, 365275015, US 6593 SPANISH FORT BLVD, SPANISH FORT, AL, 365275015, US

Contacts
Phone +1 251-300-6100

Authorized person
Name MRS. ROSE MARIE ALLEN
Role OFFICE MANAGER
Phone 2513006100

Taxonomy
Taxonomy Code 1223G0001X - General Practice Dentistry
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AZALEA CITY DENTAL 401(K) PROFIT SHARING PLAN 2023 631036832 2024-10-14 AZALEA CITY DENTAL, L.L.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 2514711516
Plan sponsor’s address 457 NORTH CRAFT HIGHWAY, MOBILE, AL, 36611

Signature of
Role Plan administrator
Date 2024-10-14
Name of individual signing SHAUN KERN
Valid signature Filed with authorized/valid electronic signature
AZALEA CITY DENTAL 401(K) PROFIT SHARING PLAN 2021 631036832 2022-10-10 AZALEA CITY DENTAL, L.L.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 2514711516
Plan sponsor’s address 457 NORTH CRAFT HIGHWAY, MOBILE, AL, 36611

Signature of
Role Plan administrator
Date 2022-10-10
Name of individual signing SHAUN KERN
AZALEA CITY DENTAL 401(K) PROFIT SHARING PLAN 2020 631036832 2021-10-14 AZALEA CITY DENTAL, L.L.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 2514711516
Plan sponsor’s address 457 NORTH CRAFT HIGHWAY, MOBILE, AL, 36611

Signature of
Role Plan administrator
Date 2021-10-14
Name of individual signing SHAUN KERN
AZALEA CITY DENTAL 401(K) PROFIT SHARING PLAN 2019 631036832 2020-10-12 AZALEA CITY DENTAL, L.L.C. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 2514711516
Plan sponsor’s address 457 NORTH CRAFT HIGHWAY, MOBILE, AL, 36611

Signature of
Role Plan administrator
Date 2020-10-12
Name of individual signing SHAUN KERN
AZALEA CITY DENTAL 401(K) PROFIT SHARING PLAN 2018 631036832 2019-10-14 AZALEA CITY DENTAL, L.L.C. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 2514711516
Plan sponsor’s address 457 NORTH CRAFT HIGHWAY, MOBILE, AL, 36611

Signature of
Role Plan administrator
Date 2019-10-14
Name of individual signing SHAUN KERN
AZALEA CITY DENTAL 401(K) PROFIT SHARING PLAN 2017 631036832 2018-09-10 AZALEA CITY DENTAL, L.L.C. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 2514711516
Plan sponsor’s address 457 NORTH CRAFT HIGHWAY, MOBILE, AL, 36611

Signature of
Role Plan administrator
Date 2018-09-10
Name of individual signing SCOTT MACRAE
AZALEA CITY DENTAL 401(K) PROFIT SHARING PLAN 2016 631036832 2017-04-10 AZALEA CITY DENTAL, L.L.C. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 2514711516
Plan sponsor’s address 457 NORTH CRAFT HIGHWAY, MOBILE, AL, 36611

Signature of
Role Plan administrator
Date 2017-04-10
Name of individual signing SCOTT MACRAE
AZALEA CITY DENTAL 401(K) PROFIT SHARING PLAN 2015 631036832 2016-06-16 AZALEA CITY DENTAL, L.L.C. 29
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 2514711516
Plan sponsor’s address 457 NORTH CRAFT HIGHWAY, MOBILE, AL, 36611

Signature of
Role Plan administrator
Date 2016-06-16
Name of individual signing SCOTT MACRAE
AZALEA CITY DENTAL 401(K) PROFIT SHARING PLAN 2015 631036832 2016-08-02 AZALEA CITY DENTAL, L.L.C. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 2514711516
Plan sponsor’s address 457 NORTH CRAFT HIGHWAY, MOBILE, AL, 36611

Signature of
Role Plan administrator
Date 2016-08-02
Name of individual signing SCOTT MACRAE
AZALEA CITY DENTAL 401(K) PROFIT SHARING PLAN 2014 631036832 2015-09-24 AZALEA CITY DENTAL, L.L.C. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 2514568406
Plan sponsor’s address 457 NORTH CRAFT HIGHWAY, CHICKASAW, AL, 36611

Signature of
Role Plan administrator
Date 2015-09-24
Name of individual signing SCOTT MACRAE

Member

Name Role
MACRAE, SCOTT CHRISTOPHER Member
KERN, SHAUN C Member
BELLERJEAU, JOHN S Member

Agent

Name Role
BELLERJEAU, JOHN S DMD Agent

Events

Event Date Event Type Old Value New Value
1995-01-03 Name Merged No data BELLERJEAU AND MACRAE (AL-GP) Non-Qualified Foreign Into Domestic

Related by officers

MACRAE, SCOTT CHRISTOPHER

Bellerjeau-MacRae Properties, L.L.C.

BELLERJEAU, JOHN S

Bellerjeau-MacRae Properties, L.L.C.

Related by address

No related companies by address

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State

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