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  5. BOULEVARD DENTAL, PLLC

BOULEVARD DENTAL, PLLC - Florida Company Profile

Company Details

Entity Name: BOULEVARD DENTAL, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

BOULEVARD DENTAL, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 13 Dec 2005 (19 years ago)
Last Event: LC AMENDMENT AND NAME CHANGE
Event Date Filed: 21 Jun 2006 (19 years ago)
Document Number: L05000118967
FEI/EIN Number 203951010

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 8475 SEMINOLE BOULEVARD, SEMINOLE, FL, 33772
Mail Address: 8475 SEMINOLE BOULEVARD, SEMINOLE, FL, 33772
ZIP code: 33772
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1114073590 2007-01-26 2020-08-22 8475 SEMINOLE BLVD, SEMINOLE, FL, 337724329, US 8475 SEMINOLE BLVD, SEMINOLE, FL, 337724329, US

Contacts
Phone +1 727-393-6025
Fax 7273975222

Authorized person
Name DR. FRANK B MOSS
Role OWNER
Phone 7273936024

Taxonomy
Taxonomy Code 122300000X - Dentist
License Number DN6079
State FL
Is Primary Yes
Taxonomy Code 122300000X - Dentist
License Number DN16886
State FL
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BOULEVARD DENTAL, PLLC 401(K) PLAN 2013 203951010 2014-04-25 BOULEVARD DENTAL, PLLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 7273936024
Plan sponsor’s address 8475 SEMINOLE BOULEVARD, SEMINOLE, FL, 33772

Signature of
Role Plan administrator
Date 2014-04-25
Name of individual signing FRANK B. MOSS
Valid signature Filed with authorized/valid electronic signature
BOULEVARD DENTAL, PLLC 401(K) PLAN 2012 203951010 2013-08-09 BOULEVARD DENTAL, PLLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 7273936024
Plan sponsor’s address 8475 SEMINOLE BOULEVARD, SEMINOLE, FL, 33772

Signature of
Role Plan administrator
Date 2013-08-09
Name of individual signing FRANK B. MOSS
Valid signature Filed with authorized/valid electronic signature
BOULEVARD DENTAL, PLLC 401(K) PLAN 2011 203951010 2012-08-06 BOULEVARD DENTAL, PLLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 7273936024
Plan sponsor’s address 8475 SEMINOLE BOULEVARD, SEMINOLE, FL, 33772

Plan administrator’s name and address
Administrator’s EIN 203951010
Plan administrator’s name BOULEVARD DENTAL, PLLC
Plan administrator’s address 8475 SEMINOLE BOULEVARD, SEMINOLE, FL, 33772
Administrator’s telephone number 7273936024

Signature of
Role Plan administrator
Date 2012-08-06
Name of individual signing FRANK B MOSS
Valid signature Filed with authorized/valid electronic signature
BOULEVARD DENTAL, PLLC 401(K) PLAN 2010 203951010 2011-07-07 BOULEVARD DENTAL, PLLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 7273936024
Plan sponsor’s address 8475 SEMINOLE BOULEVARD, SEMINOLE, FL, 33772

Plan administrator’s name and address
Administrator’s EIN 203951010
Plan administrator’s name BOULEVARD DENTAL, PLLC
Plan administrator’s address 8475 SEMINOLE BOULEVARD, SEMINOLE, FL, 33772
Administrator’s telephone number 7273936024

Signature of
Role Plan administrator
Date 2011-07-07
Name of individual signing FRANK B MOSS
Valid signature Filed with authorized/valid electronic signature
BOULEVARD DENTAL, PLLC 401(K) PLAN 2009 203951010 2010-06-08 BOULEVARD DENTAL, PLLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 7273936024
Plan sponsor’s address 8475 SEMINOLE BOULEVARD, SEMINOLE, FL, 33772

Plan administrator’s name and address
Administrator’s EIN 203951010
Plan administrator’s name BOULEVARD DENTAL, PLLC
Plan administrator’s address 8475 SEMINOLE BOULEVARD, SEMINOLE, FL, 33772
Administrator’s telephone number 7273936024

Signature of
Role Plan administrator
Date 2010-06-08
Name of individual signing FRANK B MOSS
Valid signature Filed with authorized/valid electronic signature
BOULEVARD DENTAL, PLLC 401(K) PLAN 2009 203951010 2010-05-24 BOULEVARD DENTAL, PLLC 12
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 7273936024
Plan sponsor’s address 8475 SEMINOLE BOULEVARD, SEMINOLE, FL, 33772

Plan administrator’s name and address
Administrator’s EIN 203951010
Plan administrator’s name BOULEVARD DENTAL, PLLC
Plan administrator’s address 8475 SEMINOLE BOULEVARD, SEMINOLE, FL, 33772
Administrator’s telephone number 7273936024

Signature of
Role Plan administrator
Date 2010-05-24
Name of individual signing FRANK B MOSS
Valid signature Filed with incorrect/unrecognized electronic signature

Key Officers & Management

Name Role Address
WUJICK CHRISTOPHER T Manager 8475 SEMINOLE BLVD., SEMINOLE, FL, 33772
WUJICK CHRISTOPHER T Agent 8475 SEMINOLE BLVD., SEMINOLE, FL, 33772

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G10000110226 BOULEVARD DENTAL LLC EXPIRED 2010-12-03 2015-12-31 - 8475 SEMINOLE BLVD., SEMINOLE, FL, 33772

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2014-02-16 8475 SEMINOLE BLVD., SEMINOLE, FL 33772 -
REGISTERED AGENT NAME CHANGED 2013-01-24 WUJICK, CHRISTOPHER T -
LC AMENDMENT AND NAME CHANGE 2006-06-21 BOULEVARD DENTAL, PLLC -

Documents

Name Date
ANNUAL REPORT 2024-02-16
ANNUAL REPORT 2023-03-12
ANNUAL REPORT 2022-03-04
ANNUAL REPORT 2021-01-22
ANNUAL REPORT 2020-03-20
ANNUAL REPORT 2019-04-26
ANNUAL REPORT 2018-02-23
ANNUAL REPORT 2017-03-17
ANNUAL REPORT 2016-03-26
ANNUAL REPORT 2015-03-07

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6137467709 2020-05-01 0455 PPP 8475 SEMINOLE BLVD, SEMINOLE, FL, 33772-4329
Loan Status Date 2021-08-19
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 226375
Loan Approval Amount (current) 226375
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description New Business or 2 years or less
Project Address SEMINOLE, PINELLAS, FL, 33772-4329
Project Congressional District FL-13
Number of Employees 22
NAICS code 621210
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 229122.51
Forgiveness Paid Date 2021-07-22

Companies related by officers

No other companies in our directory share the same officers as BOULEVARD DENTAL, PLLC

Companies related by address

No other companies in our directory share the same address as BOULEVARD DENTAL, PLLC

Date of last update: 02 Apr 2025

Sources: Florida Department of State

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