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  5. ROGER A. FINE, D.D.S., P.A.

ROGER A. FINE, D.D.S., P.A.

Company Details

Entity Name: ROGER A. FINE, D.D.S., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 01 Sep 1976 (48 years ago)
Date of dissolution: 29 Nov 2021 (3 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 29 Nov 2021 (3 years ago)
Document Number: 511518
FEI/EIN Number 59-1686655
Address: 6120 NW 99th Way, Parkland, FL 33076
Mail Address: 6120 NW 99TH WAY, PARKLAND, FL 33076
ZIP code: 33076
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1225247679 2007-05-22 2020-08-22 1800 W 49TH ST, SUITE 314, HIALEAH, FL, 330122900, US 1800 W 49TH ST, SUITE 314, HIALEAH, FL, 330122900, US

Contacts
Phone +1 305-558-2321

Authorized person
Name DR. ROGER ALAN FINE
Role PRESIDENT
Phone 3055582321

Taxonomy
Taxonomy Code 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
License Number DN 5189
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ROGER A. FINE, D.D.S., P.A. PROFIT SHARING PLAN 2018 591686655 2019-09-08 ROGER A. FINE, D.D.S., P.A. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-09-01
Business code 621210
Sponsor’s telephone number 9543400478
Plan sponsor’s address 6120 NW 99TH WAY, PARKLAND, FL, 330762572

Signature of
Role Plan administrator
Date 2019-09-08
Name of individual signing ROGER FINE
Valid signature Filed with authorized/valid electronic signature
ROGER A. FINE, D.D.S., P.A. PROFIT SHARING PLAN 2017 591686655 2018-09-05 ROGER A. FINE, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-09-01
Business code 621210
Sponsor’s telephone number 9543400478
Plan sponsor’s address 6120 NW 99TH WAY, PARKLAND, FL, 330762572

Signature of
Role Plan administrator
Date 2018-09-05
Name of individual signing ROGER FINE
Valid signature Filed with authorized/valid electronic signature
ROGER A. FINE, D.D.S., P.A. PROFIT SHARING PLAN 2016 591686655 2017-09-01 ROGER A. FINE, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-09-01
Business code 621210
Sponsor’s telephone number 9543400478
Plan sponsor’s address 6120 NW 99TH WAY, PARKLAND, FL, 330762572

Signature of
Role Plan administrator
Date 2017-09-01
Name of individual signing ROGER FINE
Valid signature Filed with authorized/valid electronic signature
ROGER A. FINE, D.D.S., P.A. PROFIT SHARING PLAN 2015 591686655 2016-08-10 ROGER A. FINE, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-09-01
Business code 621210
Sponsor’s telephone number 9543400478
Plan sponsor’s address 6120 NW 99TH WAY, PARKLAND, FL, 330762572

Signature of
Role Plan administrator
Date 2016-08-09
Name of individual signing ROGER FINE
Valid signature Filed with authorized/valid electronic signature
ROGER A. FINE, D.D.S., P.A. PROFIT SHARING PLAN 2014 591686655 2015-08-09 ROGER A. FINE, D.D.S., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-09-01
Business code 621210
Sponsor’s telephone number 9543400478
Plan sponsor’s address 6120 NW 99TH WAY, PARKLAND, FL, 33076

Plan administrator’s name and address
Administrator’s EIN 591686655
Plan administrator’s name ROGER A. FINE, D.D.S., P.A.
Plan administrator’s address 6120 NW 99TH WAY, PARKLAND, FL, 33076
Administrator’s telephone number 9543400478

Signature of
Role Plan administrator
Date 2015-08-09
Name of individual signing ROGER FINE
Valid signature Filed with authorized/valid electronic signature
ROGER A. FINE, D.D.S., P.A. PROFIT SHARING PLAN 2013 591686655 2014-08-12 ROGER A. FINE, D.D.S., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-09-01
Business code 621210
Sponsor’s telephone number 9543400478
Plan sponsor’s address 6120 NW 99TH WAY, PARKLAND, FL, 33076

Plan administrator’s name and address
Administrator’s EIN 591686655
Plan administrator’s name ROGER A. FINE, D.D.S., P.A.
Plan administrator’s address 6120 NW 99TH WAY, PARKLAND, FL, 33076
Administrator’s telephone number 9543400478

Signature of
Role Plan administrator
Date 2014-08-12
Name of individual signing ROGER FINE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-08-12
Name of individual signing ROGER FINE
Valid signature Filed with authorized/valid electronic signature
ROGER A. FINE, D.D.S., P.A. PROFIT SHARING PLAN 2012 591686655 2013-09-13 ROGER A. FINE, D.D.S., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-09-01
Business code 621210
Sponsor’s telephone number 9543400478
Plan sponsor’s address 6120 NW 99TH WAY, PARKLAND, FL, 33076

Plan administrator’s name and address
Administrator’s EIN 591686655
Plan administrator’s name ROGER A. FINE, D.D.S., P.A.
Plan administrator’s address 6120 NW 99TH WAY, PARKLAND, FL, 33076
Administrator’s telephone number 9543400478

Signature of
Role Plan administrator
Date 2013-09-13
Name of individual signing ROGER FINE
Valid signature Filed with authorized/valid electronic signature
ROGER A. FINE, D.D.S., P.A. PROFIT SHARING PLAN 2011 591686655 2012-09-10 ROGER A. FINE, D.D.S., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-09-01
Business code 621210
Sponsor’s telephone number 9543400478
Plan sponsor’s address 6120 NW 99TH WAY, PARKLAND, FL, 33076

Plan administrator’s name and address
Administrator’s EIN 591686655
Plan administrator’s name ROGER A. FINE, D.D.S., P.A.
Plan administrator’s address 6120 NW 99TH WAY, PARKLAND, FL, 33076
Administrator’s telephone number 9543400478

Signature of
Role Plan administrator
Date 2012-09-08
Name of individual signing ROGER FINE
Valid signature Filed with authorized/valid electronic signature
ROGER A. FINE, D.D.S., P.A. PROFIT SHARING PLAN 2010 591686655 2011-09-24 ROGER A. FINE, D.D.S., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-09-01
Business code 621210
Sponsor’s telephone number 3055582321
Plan sponsor’s address 1800 WEST 49TH STREET, SUITE 314, HIALEAH, FL, 33012

Plan administrator’s name and address
Administrator’s EIN 591686655
Plan administrator’s name ROGER A. FINE, D.D.S., P.A.
Plan administrator’s address 1800 WEST 49TH STREET, SUITE 314, HIALEAH, FL, 33012
Administrator’s telephone number 3055582321

Signature of
Role Plan administrator
Date 2011-09-24
Name of individual signing ROGER FINE
Valid signature Filed with authorized/valid electronic signature
ROGER A. FINE, D.D.S., P.A. PROFIT SHARING PLAN 2009 591686655 2010-09-11 ROGER A. FINE, D.D.S., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-09-01
Business code 621210
Sponsor’s telephone number 3055582321
Plan sponsor’s address 1800 WEST 49TH STREET, SUITE 314, HIALEAH, FL, 33012

Plan administrator’s name and address
Administrator’s EIN 591686655
Plan administrator’s name ROGER A. FINE, D.D.S., P.A.
Plan administrator’s address 1800 WEST 49TH STREET, SUITE 314, HIALEAH, FL, 33012
Administrator’s telephone number 3055582321

Signature of
Role Plan administrator
Date 2010-09-11
Name of individual signing ROGER FINE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
FINE, ROGER A., Dr. Agent 6120 NW 99TH WAY, PARKLAND, FL 33076

President

Name Role Address
FINE, ROGER A., Dr. President 6120 NW 99TH WAY, PARKLAND, FL 33076

Director

Name Role Address
FINE, ROGER A., Dr. Director 6120 NW 99TH WAY, PARKLAND, FL 33076

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2021-11-29 No data No data
CHANGE OF PRINCIPAL ADDRESS 2021-01-28 6120 NW 99th Way, Parkland, FL 33076 No data
REGISTERED AGENT ADDRESS CHANGED 2021-01-28 6120 NW 99TH WAY, PARKLAND, FL 33076 No data
REGISTERED AGENT NAME CHANGED 2013-02-02 FINE, ROGER A., Dr. No data
CHANGE OF MAILING ADDRESS 2012-01-08 6120 NW 99th Way, Parkland, FL 33076 No data

Documents

Name Date
Voluntary Dissolution 2021-11-29
ANNUAL REPORT 2021-01-28
ANNUAL REPORT 2020-01-14
ANNUAL REPORT 2019-02-11
ANNUAL REPORT 2018-01-13
ANNUAL REPORT 2017-02-09
ANNUAL REPORT 2016-01-22
ANNUAL REPORT 2015-01-10
ANNUAL REPORT 2014-01-11
ANNUAL REPORT 2013-02-02

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 06 Feb 2025

Sources: Florida Department of State

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