| Name: | STOCK DENTAL PLLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 25 Apr 2023 (2 years ago) |
| Entity Number: | 001-076-002 |
| Register Number: | 001076002 |
| County: | Madison |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 7564 HIGHWAY 72 WSTE CMADISON, AL 35758 |
| Registered Office Street Address ZIP Code: | 35758 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811672645 | 2023-06-20 | 2023-09-14 | PO BOX 70887, CLEVELAND, OH, 441900887, US | 7564 HIGHWAY 72 W STE C, MADISON, AL, 357589437, US | |||||||||||||
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| Phone | +1 256-690-5099 |
Authorized person
| Name | MICHELLE JACOMINO-BARNES |
| Role | DIRECTOR CREDENTIALING & ENROLLMENT |
| Phone | 8132709497 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role |
|---|---|
| STOCK, MICHAEL A. | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
