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Dothan Endo, LLC

Details

Name: Dothan Endo, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 05 Sep 2023 (a year ago) (Companies founded in September 2023)
Entity Number: 001-097-832
Register Number: 001097832
ZIP code: 35216 (Companies in Jefferson, 35216)
County: Jefferson
Place of Formation: Alabama
Registered Office Street Address: 1771 Independence Ct., #3Vestavia Hills, AL 35216

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1811760317 2023-11-06 2023-11-06 220 HEALTHWEST DR STE 1, DOTHAN, AL, 363032047, US 220 HEALTHWEST DR STE 1, DOTHAN, AL, 363032047, US

Contacts

Phone +1 334-793-7687
Fax 3347930067

Authorized person

Name DR. LEE VAN CARROLL
Role OWNER/ENDODONTIST
Phone 3347937687

Taxonomy

Taxonomy Code 1223E0200X - Endodontist
Is Primary Yes

Agent

Name Role
HighFive Endodontics, P.C. Agent

Date of last update: 18 Aug 2024

Sources: Alabama Secretary of State