| Name: | GD AL Clairmont, PLLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 26 Jan 2024 (10 months ago) |
| Entity Number: | 001-118-244 |
| Register Number: | 001118244 |
| 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 | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790543783 | 2024-03-13 | 2024-03-13 | 2940 CLAIRMONT AVE S, BIRMINGHAM, AL, 352051014, US | 2940 CLAIRMONT AVE S, BIRMINGHAM, AL, 352051014, US | |||||||||||||
|
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| Phone | +1 205-277-2297 |
Authorized person
| Name | CHAD HENDRICKS |
| Role | CREDENTIALING |
| Phone | 6128590444 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role |
|---|---|
| FOREST E. WATERS | Member |
| Name | Role |
|---|---|
| CAPITOL CORPORATE SERVICES, INC. | Agent |
Date of last update: 18 Aug 2024
Sources: Alabama Secretary of State
