| Name: | PDA Orthodontics Trussville, PLLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 23 Oct 2020 (4 years ago) (Companies founded in October 2020) |
| Entity Number: | 000-791-983 |
| Register Number: | 000791983 |
| ZIP code: | 35244 (Companies in Jefferson, 35244) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 3000 SOUTHLAKE PARK, UNIT 200BIRMINGHAM, AL 35244 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043815590 | 2020-12-02 | 2020-12-02 | 5336 STADIUM TRACE PKWY STE 112, HOOVER, AL, 352444581, US | 4901 DEERFOOT PKWY STE 101, TRUSSVILLE, AL, 351732697, US | |||||||||||||||||
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| Phone | +1 205-988-9678 |
| Fax | 2059889065 |
| Phone | +1 205-508-7135 |
Authorized person
| Name | DR. BENJAMIN EARL SAMUELSON |
| Role | OWNER/ORTHODONTIST |
| Phone | 2059100143 |
Taxonomy
| Taxonomy Code | 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SAMUELSON, BEN | Organizer | 3000 SOUTHLAKE PARK, UNIT 200BIRMINGHAM, AL 35244-6210 |
| Name | Role | Address |
|---|---|---|
| SAMUELSON, BEN | Agent | 3000 SOUTHLAKE PARK, UNIT 200BIRMINGHAM, AL 35244-6210 |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
