| Name: | GD AL SDR, PLLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 30 Nov 2022 (2 years ago) |
| Entity Number: | 001-051-274 |
| Register Number: | 001051274 |
| County: | Montgomery |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 2 NORTH JACKSON ST STE 605MONTGOMERY, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255033007 | 2023-03-17 | 2023-03-17 | 4730 WOODMERE BLVD, MONTGOMERY, AL, 361063065, US | 4730 WOODMERE BLVD, MONTGOMERY, AL, 361063065, US | |||||||||||||
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| Phone | +1 334-277-5665 |
Authorized person
| Name | CHAD HENDRICKS |
| Role | CREDENTIALING |
| Phone | 6128590444 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CAPITOL CORPORATE SERVICES, INC | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
