| Entity Name: | DAVID A. WAGNER D.D.S. L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Dec 2012 (12 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 25 Jan 2018 (7 years ago) |
| Document Number: | L12000157280 |
| FEI/EIN Number | 46-1582227 |
| Address: | 3023 EASTLAND BLVD., 112, CLEARWATER, FL, 33761 |
| Mail Address: | 642 HARBOR ISLAND, CLEARWATER, FL, 33767 |
| ZIP code: | 33761 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952855470 | 2016-08-12 | 2017-02-28 | 3023 EASTLAND BLVD, SUITE 112, CLEARWATER, FL, 337614106, US | 3023 EASTLAND BLVD, SUITE 112, CLEARWATER, FL, 337614106, US | |||||||||||||||||||||||||||
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| Phone | +1 727-797-5161 |
| Fax | 7277975121 |
Authorized person
| Name | DR. DAVID ALAN WAGNER |
| Role | OWNER/DENTIST |
| Phone | 7277975161 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN13625 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 332BC3200X - Customized Equipment (DME) |
| License Number | DN13625 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| WAGNER PATRICIA L | Agent | 642 HARBOR ISLAND, CLEARWATER, FL, 33767 |
| Name | Role | Address |
|---|---|---|
| WAGNER DAVID A | Managing Member | 642 HARBOR ISLAND, CLEARWATER, FL, 33767 |
| WAGNER PATRICIA L | Managing Member | 642 HARBOR ISLAND, CLEARWATER, FL, 33767 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2018-01-25 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| REINSTATEMENT | 2015-03-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2015-03-23 | WAGNER, PATRICIA L | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-02-26 |
| ANNUAL REPORT | 2019-02-21 |
| REINSTATEMENT | 2018-01-25 |
| ANNUAL REPORT | 2016-01-26 |
| REINSTATEMENT | 2015-03-23 |
| Florida Limited Liability | 2012-12-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
