| Name: | Genesis Dental Group Homewood, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 26 Sep 2017 (7 years ago) |
| Date of dissolution: | 30 Dec 2023 |
| Entity Number: | 000-404-039 |
| Register Number: | 000404039 |
| ZIP code: | 36106 |
| County: | Montgomery |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 3150 ZELDA COURTMONTGOMERY, AL 36106 |
| Authorized Capital: | 10,000@$.001/PV |
Activities
PROVIDE DENTISTRY/ANCILLARY SERVICES;ANY/ALL LAWFUL BUSINESS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528577129 | 2017-09-26 | 2017-09-26 | 3150 ZELDA CT, MONTGOMERY, AL, 361062607, US | 2045 BROOKWOOD MEDICAL CTR DR STE 4, BIRMINGHAM, AL, 352096809, US | |||||||||||||||||||||
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| Phone | +1 334-676-2320 |
| Phone | +1 205-871-6600 |
| Fax | 2058716680 |
Authorized person
| Name | PAT HOLT |
| Role | ADMINISTRATOR |
| Phone | 3346762320 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 6138 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| GENESIS DENTAL GROUP P.C. | Agent |
| Name | Role | Address |
|---|---|---|
| STEINEKER, ART | Director | 4730 WOODMERE BLVDMONTGOMERY, AL 36101 |
| DILLON, DARREN | Director | 4730 WOODMERE BLVDMONTGOMERY, AL 36101 |
| LIEUX, DAVID | Director | 3150 ZELDA CTMONTGOMERY, AL 36101 |
| WATERS, FORREST | Director | 3150 ZELDA CTMONTGOMERY, AL 36101 |
| Name | Role | Address |
|---|---|---|
| DILLON, DARREN | Incorporator | 4730 WOODMERE BLVDMONTGOMERY, AL 36101 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
