| Entity Name: | SHALIMAR FAMILY DENTISTRY, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Jun 2014 (11 years ago) |
| Last Event: | LC AMENDED/RESTATED ARTICLE/NAME CHANGE |
| Event Date Filed: | 24 May 2017 (8 years ago) |
| Document Number: | L14000104598 |
| FEI/EIN Number | 47-1402765 |
| Address: | 1 11TH AVENUE #D3, SHALIMAR, FL, 32579, US |
| Mail Address: | 1 11TH AVENUE #D3, SHALIMAR, FL, 32579, US |
| ZIP code: | 32579 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932111564 | 2006-08-12 | 2014-12-08 | 1 ELEVENTH AVENUE, D-3, SHALIMAR, FL, 32579, US | 1 ELEVENTH AVENUE, D-3, SHALIMAR, FL, 32579, US | |||||||||||||||
|
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| Phone | +1 850-651-6700 |
| Fax | 8506090796 |
Authorized person
| Name | LISA FLETCHER |
| Role | OWNER |
| Phone | 8506516700 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Moeller Gary A | Agent | 1 11TH AVENUE #D3, SHALIMAR, FL, 32579 |
| Name | Role | Address |
|---|---|---|
| Moeller Gary A | Manager | 1 11TH AVENUE #D3, SHALIMAR, FL, 32579 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-11-01 | 1 11TH AVENUE #D3, SHALIMAR, FL 32579 | No data |
| CHANGE OF MAILING ADDRESS | 2025-11-01 | 1 11TH AVENUE #D3, SHALIMAR, FL 32579 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-11-01 | 1 11TH AVENUE #D3, SHALIMAR, FL 32579 | No data |
| CHANGE OF MAILING ADDRESS | 2024-11-01 | 1 11TH AVENUE #D3, SHALIMAR, FL 32579 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-02-08 | Moeller, Gary Anthony | No data |
| LC AMENDED/RESTATED ARTICLE/NAME CHANGE | 2017-05-24 | SHALIMAR FAMILY DENTISTRY, PLLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-02-08 |
| ANNUAL REPORT | 2020-01-14 |
| ANNUAL REPORT | 2019-02-20 |
| ANNUAL REPORT | 2018-03-20 |
| LC Amended/Restated Article/NC | 2017-05-24 |
| ANNUAL REPORT | 2017-04-11 |
| ANNUAL REPORT | 2016-01-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
