| Name: | Huntsville Periodontal and Implant Specialists, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 08 May 2023 (2 years ago) |
| Entity Number: | 001-078-188 |
| Register Number: | 001078188 |
| County: | Limestone |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 119 Bayard PlaceMadison, AL 35756 |
| Registered Office Street Address ZIP Code: | 35756 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578347365 | 2023-08-22 | 2023-08-22 | 7736 MADISON BLVD STE 2, HUNTSVILLE, AL, 358063658, US | 7736 MADISON BLVD STE 2, HUNTSVILLE, AL, 358063658, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 256-289-8440 |
| Fax | 2562579808 |
Authorized person
| Name | DR. BRITANY FABIAN MATIN |
| Role | DENTIST |
| Phone | 2562898440 |
Taxonomy
| Taxonomy Code | 1223P0300X - Periodontist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Lisa Shi Franks, DMD, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| Jon J Rutledge, LLC | Organizer | 300 Vestavia Parkway, Suite 2300Birmingham, AL 35216 |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
