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Russellville Family Dentistry, LLC

Details

Name: Russellville Family Dentistry, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 01 Nov 2022 (2 years ago) (Companies founded in November 2022)
Entity Number: 001-047-126
Register Number: 001047126
ZIP code: 35633 (Companies in Lauderdale, 35633)
County: Lauderdale
Place of Formation: Alabama
Registered Office Street Address: 105 W Meadow Hill DrFlorence, AL 35633

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1205543204 2022-10-31 2022-10-31 510 ENGLE DR SE, RUSSELLVILLE, AL, 356532749, US 510 ENGLE DR SE, RUSSELLVILLE, AL, 356532749, US

Contacts

Phone +1 256-332-6073
Fax 2563326655

Authorized person

Name DR. MIKE MCLEARY
Role DENTIST
Phone 2563326073

Taxonomy

Taxonomy Code 1223G0001X - General Practice Dentistry
Is Primary Yes

Agent

Name Role
McCleary, Michael Agent

Organizer

Name Role Address
Legalzoom.com, Inc. Organizer 101 N Brand Blvd., 11th FlGlendale, CA 91203

Date of last update: 17 Aug 2024

Sources: Alabama Secretary of State