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  5. NATHAN HALL, DMD, PL

NATHAN HALL, DMD, PL

Company Details

Entity Name: NATHAN HALL, DMD, PL
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 24 Apr 2012 (13 years ago)
Document Number: L12000055401
FEI/EIN Number 45-5130160
Address: 438 ADMIRAL COURT, DESTIN, FL 32541
Mail Address: 4484 Legendary Drive, Suite B, DESTIN, FL 32541
ZIP code: 32541
County: Okaloosa
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1073861704 2012-08-28 2012-08-28 4484 LEGENDARY DR, SUITE B, DESTIN, FL, 32541, US 4484 LEGENDARY DR, SUITE B, DESTIN, FL, 32541, US

Contacts
Phone +1 850-460-2801
Fax 8504602817

Authorized person
Name DR. NATHAN C HALL
Role OWNER/DENTIST
Phone 8504602801

Taxonomy
Taxonomy Code 1223G0001X - General Practice Dentistry
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NATHAN HALL, DMD, PL 401(K) PLAN 2014 455130160 2015-07-10 NATHAN HALL, DMD, PL 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-08-01
Business code 621210
Sponsor’s telephone number 8504602801
Plan sponsor’s address 4484 LEGENDARY DRIVE, SUITE B, DESTIN, FL, 32541

Signature of
Role Plan administrator
Date 2015-07-10
Name of individual signing NATHAN HALL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-10
Name of individual signing NATHAN HALL
Valid signature Filed with authorized/valid electronic signature
NATHAN HALL, DMD, PL 401(K) PLAN 2013 455130160 2014-08-28 NATHAN HALL, DMD, PL 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-08-01
Business code 621210
Sponsor’s telephone number 8504602801
Plan sponsor’s address 4484 LEGENDARY DRIVE, SUITE B, DESTIN, FL, 32541

Signature of
Role Plan administrator
Date 2014-08-26
Name of individual signing NATHAN HALL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-08-26
Name of individual signing NATHAN HALL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
HALL, NATHANIEL CD.M.D. Agent 4484 Legendary Drive, Suite B, DESTIN, FL 32541

Managing Member

Name Role Address
HALL, NATHANIEL C Managing Member 438 ADMIRAL COURT, DESTIN, FL 32541

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2013-07-19 438 ADMIRAL COURT, DESTIN, FL 32541 No data
REGISTERED AGENT ADDRESS CHANGED 2013-07-19 4484 Legendary Drive, Suite B, DESTIN, FL 32541 No data

Documents

Name Date
ANNUAL REPORT 2024-01-18
ANNUAL REPORT 2023-01-05
ANNUAL REPORT 2022-01-12
ANNUAL REPORT 2021-01-06
ANNUAL REPORT 2020-01-09
ANNUAL REPORT 2019-01-11
ANNUAL REPORT 2018-01-17
ANNUAL REPORT 2017-01-10
ANNUAL REPORT 2016-01-08
ANNUAL REPORT 2015-01-09

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
4216217104 2020-04-13 0491 PPP 4484 LEGENDARY DR STE B, DESTIN, FL, 32541-5324
Loan Status Date 2021-05-15
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 65527
Loan Approval Amount (current) 65527
Undisbursed Amount 0
Franchise Name -
Lender Location ID 19248
Servicing Lender Name Synovus Bank
Servicing Lender Address 1148 Broadway, COLUMBUS, GA, 31901-2429
Rural or Urban Indicator U
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address DESTIN, OKALOOSA, FL, 32541-5324
Project Congressional District FL-01
Number of Employees 8
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 19248
Originating Lender Name Synovus Bank
Originating Lender Address COLUMBUS, GA
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 66169.7
Forgiveness Paid Date 2021-04-08
8738118307 2021-01-30 0491 PPS 4484 Legendary Dr Ste B, Destin, FL, 32541-5378
Loan Status Date 2021-08-17
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 65527
Loan Approval Amount (current) 65527
Undisbursed Amount 0
Franchise Name -
Lender Location ID 19248
Servicing Lender Name Synovus Bank
Servicing Lender Address 1148 Broadway, COLUMBUS, GA, 31901-2429
Rural or Urban Indicator U
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address Destin, OKALOOSA, FL, 32541-5378
Project Congressional District FL-01
Number of Employees 8
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 19248
Originating Lender Name Synovus Bank
Originating Lender Address COLUMBUS, GA
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 65803.47
Forgiveness Paid Date 2021-07-07

Related by officers

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Related by address

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Date of last update: 22 Feb 2025

Sources: Florida Department of State

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