| Name: | Childersburg GR Dental, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Series Limited Liability Company |
| Status: | Exists |
| Date of registration: | 04 Apr 2018 (7 years ago) |
| Entity Number: | 000-514-851 |
| Register Number: | 000514851 |
| ZIP code: | 35044 |
| County: | Talladega |
| Place of Formation: | Talladega County |
| Registered Office Street Address: | 138 9TH AVE SWCHILDERSBURGE, AL 35044 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144726621 | 2018-04-03 | 2021-07-28 | 138 9TH AVE SW, CHILDERSBURG, AL, 350441642, US | 138 9TH AVE SW, CHILDERSBURG, AL, 350441642, US | |||||||||||||||||||||
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| Phone | +1 256-378-3322 |
Authorized person
| Name | THOMAS G RICE III |
| Role | MEMBER |
| Phone | 7062077133 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | No |
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | D5959C1 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| RICE, THOMAS G III | Agent |
| Name | Role | Address |
|---|---|---|
| MATTOX, KELLY | Organizer | 1406 CALIBRE SPRINGS WAY NEATLANTA, GA 30342 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5703398306 | 2021-01-25 | 0459 | PPS | 138, CHILDERSBURG, AL, 35044 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
