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MARTIN KIDS DENTAL HEALTH TEAM OF LAKE CITY, PLLC

Company Details

Entity Name: MARTIN KIDS DENTAL HEALTH TEAM OF LAKE CITY, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 23 Jan 2014 (11 years ago)
Document Number: L14000012899
FEI/EIN Number 46-4604246
Address: 973 SW State Road 47, Lake City, FL 32025
Mail Address: 973 SW State Road 47, Lake City, FL 32025
ZIP code: 32025
County: Columbia
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1538583802 2014-02-07 2014-02-07 875 SW STATE ROAD 47, LAKE CITY, FL, 320250433, US 875 SW STATE ROAD 47, LAKE CITY, FL, 320250433, US

Contacts

Phone +1 386-752-8200

Authorized person

Name DR. CELIA S MARTIN
Role OWNER
Phone 3867528200

Taxonomy

Taxonomy Code 1223P0221X - Pediatric Dentist
License Number DN19462
State FL
Is Primary Yes

Agent

Name Role Address
MARTIN, CELIA S Agent 973 SW State Road 47, Lake City, FL 32025

Manager

Name Role Address
MARTIN, CELIA S Manager 973 SW State Road 47, Lake City, FL 32025

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2021-01-11 973 SW State Road 47, Lake City, FL 32025 No data
CHANGE OF PRINCIPAL ADDRESS 2019-03-07 973 SW State Road 47, Lake City, FL 32025 No data
CHANGE OF MAILING ADDRESS 2019-03-07 973 SW State Road 47, Lake City, FL 32025 No data

Documents

Name Date
ANNUAL REPORT 2024-01-29
ANNUAL REPORT 2023-02-20
ANNUAL REPORT 2022-01-20
ANNUAL REPORT 2021-01-11
ANNUAL REPORT 2020-01-14
ANNUAL REPORT 2019-03-07
ANNUAL REPORT 2018-02-06
ANNUAL REPORT 2017-02-10
ANNUAL REPORT 2016-03-15
ANNUAL REPORT 2015-02-25

Date of last update: 22 Jan 2025

Sources: Florida Department of State