| Entity Name: | DALTON PERIODONTAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 16 Aug 2013 (11 years ago) |
| Document Number: | L13000118112 |
| FEI/EIN Number | 46-3396694 |
| Address: | 4511 W Gandy Blvd, TAMPA, FL 33611 |
| Mail Address: | 4511 W Gandy Blvd, TAMPA, FL 33611 |
| ZIP code: | 33611 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700281201 | 2014-10-27 | 2014-10-27 | 4511 W GANDY BLVD, TAMPA, FL, 336113303, US | 4511 W GANDY BLVD, TAMPA, FL, 336113303, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 813-872-8300 |
Authorized person
| Name | HILARY DALTON |
| Role | OWNER |
| Phone | 8138728300 |
Taxonomy
| Taxonomy Code | 1223P0300X - Periodontist |
| License Number | DN-14976 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BANKS, MICHAEL A | Agent | 4511 W Gandy Blvd, TAMPA, FL 33611 |
| Name | Role | Address |
|---|---|---|
| BANKS, HILARY DALTON | Managing Member | 4511 W Gandy Blvd, TAMPA, FL 33611 |
| Name | Role | Address |
|---|---|---|
| BANKS, MICHAEL A | Manager | 4511 W Gandy Blvd, TAMPA, FL 33611 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2015-02-12 | 4511 W Gandy Blvd, TAMPA, FL 33611 | No data |
| CHANGE OF MAILING ADDRESS | 2015-02-12 | 4511 W Gandy Blvd, TAMPA, FL 33611 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-02-12 | 4511 W Gandy Blvd, TAMPA, FL 33611 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-03 |
| ANNUAL REPORT | 2024-01-23 |
| ANNUAL REPORT | 2023-02-08 |
| ANNUAL REPORT | 2022-01-25 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-01-13 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-01-30 |
| ANNUAL REPORT | 2016-02-22 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
