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DIXIE DENTAL CENTER, PSC

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Company Details

Name: DIXIE DENTAL CENTER, PSC
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 15 Oct 1990 (35 years ago)
Organization Date: 15 Oct 1990 (35 years ago)
Last Annual Report: 23 Jun 2020 (5 years ago)
Organization Number: 0278443
ZIP code: 40222
City: Louisville, Bancroft, Bellemeade, Crossgate, Glenvie...
Primary County: Jefferson County
Principal Office: 905 OXMOOR WOODS PKWY., LOUISVILLE, KY 40222
Place of Formation: KENTUCKY
Authorized Shares: 1000

Registered Agent

Name Role
ROD FULTZ Registered Agent

Signature

Name Role
Rod B. Fultz Signature
Rod Fultz Signature

Director

Name Role
Rod Fultz Director
ROD FULTZ, D.M.D. Director

Shareholder

Name Role
Rod Fultz Shareholder

Sole Officer

Name Role
Rod Fultz Sole Officer

Incorporator

Name Role
ROD FULTZ, D.M.D. Incorporator

National Provider Identifier

NPI Number:
1962552042

Authorized Person:

Name:
DR. RODNEY BRENT FULTZ
Role:
SEC TREAS
Phone:

Taxonomy:

Selected Taxonomy:
261QD0000X - Dental Clinic/Center
Is Primary:
Yes

Contacts:

Filings

Name File Date
Administrative Dissolution 2021-10-19
Annual Report 2020-06-23
Annual Report 2019-06-20
Annual Report 2018-06-20
Annual Report 2017-06-20

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Sources: Kentucky Secretary of State