| Name: | SRD Russellville, PLLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 13 May 2022 (3 years ago) |
| Entity Number: | 001-019-832 |
| Register Number: | 001019832 |
| County: | Colbert |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 110 East 5th StreetTuscumbia, AL 35674 |
| Registered Office Street Address ZIP Code: | 35674 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730810920 | 2022-06-20 | 2022-07-06 | PO BOX 740979, TUSCUMBIA, AL, 356747423, US | 531 SAINT CLAIR ST SE, RUSSELLVILLE, AL, 356532719, US | |||||||||||||
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| Phone | +1 256-332-6888 |
Authorized person
| Name | CHRISTYN SHIELDS |
| Role | CONTROLLER |
| Phone | 2563205903 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Sage, Joshua | Organizer | 402 Enterprise DriveOxford, MS 38655 |
| Name | Role |
|---|---|
| Gardiner, James DMD | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
