| Name: | MidSouth Dental PLLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 20 Oct 2023 (a year ago) (Companies founded in October 2023) |
| Entity Number: | 001-104-607 |
| Register Number: | 001104607 |
| ZIP code: | 36303 (Companies in Houston, 36303) |
| County: | Houston |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 113 Camellia DriveDothan, AL 36303 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891555140 | 2024-03-21 | 2024-06-05 | PO BOX 70887, CLEVELAND, OH, 441900887, US | 6941 EASTCHASE LOOP, MONTGOMERY, AL, 361176876, US | |||||||||||||||
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| Phone | +1 334-530-5000 |
| Fax | 3342151983 |
Authorized person
| Name | VALERIE HAMILTON |
| Role | DIRECTOR OF CONTRACTING |
| Phone | 3154546000 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Tolbert, Kanecia L D.D.S. | Agent |
Date of last update: 18 Aug 2024
Sources: Alabama Secretary of State
