Admin Client || Dee Karawadra

Created On May, 02 2025 15:29pm ID #8026 Back

Merchant (Business) DBA Name : Pediatric Dental Specialist of Lafayette

Business Legal Name : Pediatric Dental Specialist of Lafayette, LLC

Contact Name : Alexis DeJean

Contact Phone Number : 337-722-1510

Physical Address : 854 Kaliste Saloom Road, Lafayette, LA, USA

City : Lafayette

State : LA

Country : USA

Zip : 70508

Email Address : [email protected]

<?xml version="1.0"?>
<object>
  <sales_number>12232233</sales_number>
  <sales_office/>
  <sales_signing_rep/>
  <irs_tax_id_type>Employer Identification Number</irs_tax_id_type>
  <irs_tax_id_no>33-1485987</irs_tax_id_no>
  <ownership_type>LLC</ownership_type>
  <business_incorporated>Louisiana (LA)</business_incorporated>
  <business_description>Pediatric Dental Services</business_description>
  <mailing_address>854 Kaliste Saloom Road, Lafayette, LA, USA</mailing_address>
  <mailing_city>Lafayette</mailing_city>
  <mailing_state>LA</mailing_state>
  <mailing_zip>70508</mailing_zip>
  <business_phone>337-722-1510</business_phone>
  <contact_first_name>Alexis</contact_first_name>
  <contact_last_name>DeJean</contact_last_name>
  <contact_phone>337-722-1510</contact_phone>
  <location_address>854 Kaliste Saloom Road, Lafayette, LA, USA</location_address>
  <location_city>Lafayette</location_city>
  <location_state>LA</location_state>
  <location_zip>70508</location_zip>
  <avg_ticket_amount>350.00</avg_ticket_amount>
  <ave_month_volume>150000.00</ave_month_volume>
  <bank_name>Fifth Third Bank</bank_name>
  <bank_transit_number>042000314</bank_transit_number>
  <bank_dda_no>7995430993</bank_dda_no>
  <gross_vs_net>Gross Settlement</gross_vs_net>
  <refund_policy/>
  <owner1_first_name>Seth</owner1_first_name>
  <owner1_last_name>DeJean</owner1_last_name>
  <owner1_home_address>110 Crescent Ridge Place</owner1_home_address>
  <owner1_home_city>Lafayette</owner1_home_city>
  <owner1_home_state>LA</owner1_home_state>
  <owner1_home_zip>70503</owner1_home_zip>
  <owner1_home_phone>337-417-0601</owner1_home_phone>
  <owner1_title>Owner</owner1_title>
  <owner1_ownership_perc>100</owner1_ownership_perc>
  <owner1_dob>1985-02-08</owner1_dob>
  <owner1_social_securrity_no/>
  <owner1_form_of_id>Drivers License</owner1_form_of_id>
  <owner1_number>007955291</owner1_number>
  <owner1_expired>2028-02-08</owner1_expired>
  <owner1_issuer_state>LA</owner1_issuer_state>
  <owner1_issued_date>2022-01-12</owner1_issued_date>
</object>

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