| Name: | Pediatric Dental Associates of Hoover, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 02 Feb 2022 (3 years ago) |
| Entity Number: | 001-000-734 |
| Register Number: | 001000734 |
| County: | Jefferson |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 3000 Southlake Park, Suite 200Birmingham, AL 35244 |
| Registered Office Street Address ZIP Code: | 35244 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043954647 | 2022-04-21 | 2022-04-21 | 5336 STADIUM TRACE PKWY STE 112, HOOVER, AL, 352444581, US | 5336 STADIUM TRACE PKWY STE 112, HOOVER, AL, 352444581, US | |||||||||||||
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| Phone | +1 205-988-9678 |
Authorized person
| Name | BENJAMIN EARL SAMUELSON |
| Role | ORTHODONTIST/OWNER |
| Phone | 2059100143 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Chambliss, Richard B Jr. | Organizer | 3000 Southlake Park, Ste 200Birmingham, AL 35244 |
| Name | Role | Address |
|---|---|---|
| Chambliss, Richard B Jr. | Agent | 3000 Southlake Park, Ste 200Birmingham, AL 35244 |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
