| Entity Name: | SOUTH FLORIDA DENTISTRY FOR CHILDREN, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Feb 1974 (51 years ago) |
| Document Number: | 605046 |
| FEI/EIN Number | 591541047 |
| Address: | 10188 NW 31st Street, CORAL SPRINGS, FL, 33065, US |
| Mail Address: | 10188 NW 31st Street, CORAL SPRINGS, FL, 33065, US |
| ZIP code: | 33065 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073680161 | 2006-11-30 | 2017-04-21 | 10188 NW 31ST STREET, CORAL SPRINGS, FL, 33065, US | 10188 NW 31ST STREET, CORAL SPRINGS, FL, 33065, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 954-752-7651 |
| Fax | 9543454188 |
Authorized person
| Name | DR. JAMES G. BENNETT JR. |
| Role | PRESIDENT/SOUTH FLORIDA DENTISTRY |
| Phone | 9547527651 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| License Number | 8277 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| License Number | 15103 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| License Number | DN17768 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| BENNETT JAMES G | Agent | 10188 NW 31st Street, CORAL SPRINGS, FL, 33065 |
| Name | Role | Address |
|---|---|---|
| BENNETT JAMES G | President | 10188 NW 31st Street, CORAL SPRINGS, FL, 33065 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2013-09-16 | No data | No data |
| NAME CHANGE AMENDMENT | 2011-01-24 | SOUTH FLORIDA DENTISTRY FOR CHILDREN, P.A. | No data |
| REINSTATEMENT | 2011-01-14 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| NAME CHANGE AMENDMENT | 1992-05-08 | SOUTH FLORIDA DENTISTRY FOR CHILDREN & ORTHODONTICS, P.A. | No data |
| NAME CHANGE AMENDMENT | 1992-02-17 | KLEIN, GREENFIELD, STEPHENS & BAZOS, D.D.S., P.A. | No data |
| NAME CHANGE AMENDMENT | 1981-10-09 | KLEIN, GREENFIELD & STEPHENS, D.D.S., P.A. | No data |
| NAME CHANGE AMENDMENT | 1979-11-07 | KLEIN GREENFIELD, D.D.S., P.A. | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
