| Name: | Cranfill Dental of AL LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 02 Oct 2017 (7 years ago) |
| Entity Number: | 000-404-640 |
| Register Number: | 000404640 |
| ZIP code: | 35653 |
| County: | Franklin |
| Place of Formation: | Montgomery County |
| Registered Office Street Address: | 523 GANDY STREET NE STE ARUSSELLVILLE, AL 35653 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891201430 | 2017-12-19 | 2018-02-16 | 12910 SHELBYVILLE RD STE 300, LOUISVILLE, KY, 402432404, US | 150 S PERRY ST, MONTGOMERY, AL, 361044227, US | |||||||||||||||||||
|
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| Phone | +1 502-244-2441 |
| Fax | 5022544069 |
Authorized person
| Name | JOY L PAYNE |
| Role | CREDENTIALING MANAGER |
| Phone | 5022442441 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | No |
| Name | Role |
|---|---|
| AMBER WEST | Agent |
| Name | Role | Address |
|---|---|---|
| AMMON, RANDY | Organizer | 12910 SHELBYVILLE RD STE 300LOUISVILLE, KY 40243 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
