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Childersburg Family Dental, LLC

Details

Name: Childersburg Family Dental, LLC
Jurisdiction: Alabama
Legal type: Domestic Professional Limited Liability Company
Status: Exists
Date of registration: 06 Apr 2022 (3 years ago) (Companies founded in April 2022)
Entity Number: 001-012-942
Register Number: 001012942
ZIP code: 35222 (Companies in Jefferson, 35222)
County: Jefferson
Place of Formation: Alabama
Registered Office Street Address: 3810 10th Avenue SouthBirmingham, AL 35222

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1467171249 2022-08-24 2022-08-24 3810 10TH AVE S, BIRMINGHAM, AL, 352224206, US 138 9TH AVE SW, CHILDERSBURG, AL, 350441642, US

Contacts

Phone +1 205-500-9062
Phone +1 256-378-3127

Authorized person

Name ROXANNE WEAVER
Role DENTIST, OWNER
Phone 2566941958

Taxonomy

Taxonomy Code 261QD0000X - Dental Clinic/Center
Is Primary Yes

Agent

Name Role
Weaver, Roxanne M Agent

Organizer

Name Role Address
Jon J Rutledge, LLC Organizer 300 Vestavia Parkway, Suite 2300Birmingham, AL 35216

Date of last update: 17 Aug 2024

Sources: Alabama Secretary of State