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BREATHITT DENTAL CLINIC, PSC

Company Details

Name: BREATHITT DENTAL CLINIC, PSC
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 19 Feb 2001 (24 years ago)
Organization Date: 19 Feb 2001 (24 years ago)
Last Annual Report: 05 Jul 2016 (9 years ago)
Organization Number: 0510842
ZIP code: 41702
City: Hazard
Primary County: Perry County
Principal Office: P.O. BOX 854, HAZARD, KY 41702
Place of Formation: KENTUCKY
Authorized Shares: 1000

Registered Agent

Name Role
ROGER D. CAMPBELL Registered Agent

Sole Officer

Name Role
Roger Campbell Sole Officer

Secretary

Name Role
KIM CAMPBELL Secretary

Shareholder

Name Role
Roger Campbell Shareholder

Incorporator

Name Role
ROGER D. CAMPBELL Incorporator

National Provider Identifier

NPI Number:
1942577697

Authorized Person:

Name:
DR. ROGER CAMPBELL
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fax:
6066664021

Filings

Name File Date
Administrative Dissolution 2017-10-09
Annual Report 2016-07-05
Annual Report 2015-07-27
Annual Report 2014-08-14
Annual Report 2013-06-24

Sources: Kentucky Secretary of State