| Name: | Grissom Endodontics and Microsurgery PLLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 10 May 2022 (3 years ago) |
| Entity Number: | 001-019-030 |
| Register Number: | 001019030 |
| County: | Baldwin |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 27880 NORTH MAIN STREET SUITE ADaphne, AL 36526 |
| Registered Office Street Address ZIP Code: | 36526 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891411658 | 2022-10-13 | 2022-10-13 | 27880 N MAIN ST STE A, DAPHNE, AL, 365267080, US | 27880 N MAIN ST STE A, DAPHNE, AL, 365267080, US | |||||||||||||||
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| Phone | +1 251-383-3636 |
| Fax | 2513833637 |
Authorized person
| Name | DR. AUSTYN COOPER GRISSOM |
| Role | ENDODONTIST |
| Phone | 2513833636 |
Taxonomy
| Taxonomy Code | 1223E0200X - Endodontist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Grissom, Austyn C | Agent |
| Name | Role | Address |
|---|---|---|
| Austyn Grissom | Member | 703 Olive AvenueFairhope, AL 36532 |
| Maggie Grissom | Member | 703 Olive AvenueFairhope, AL 36532 |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
