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FOREST PARK DENTAL, PLLC - Florida Company Profile

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Company Details

Entity Name: FOREST PARK DENTAL, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Inactive
Date Filed: 25 May 2017 (8 years ago)
Date of dissolution: 23 Sep 2022 (3 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 23 Sep 2022 (3 years ago)
Document Number: L17000115652
FEI/EIN Number 82-2014611
Address: 707 JENKS AVE., PANAMA CITY, FL, 32405, US
Mail Address: 707 JENKS AVE., PANAMA CITY, FL, 32405, US
ZIP code: 32405
City: Panama City
County: Bay
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
- Agent -
THOMPSON KRISTA President 707 JENKS AVE., PANAMA CITY, FL, 32405

National Provider Identifier

NPI Number:
1922529916

Authorized Person:

Name:
SUSAN STEWART
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
822014611
Plan Year:
2023
Number Of Participants:
18
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
19
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
18
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
15
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 - -
REGISTERED AGENT ADDRESS CHANGED 2020-06-23 2620 JENKS AVE., PANAMA CITY, FL 32401 -
CHANGE OF MAILING ADDRESS 2019-11-22 707 JENKS AVE., PANAMA CITY, FL 32405 -
REGISTERED AGENT NAME CHANGED 2019-11-22 Blue Waters Dental Group, PA. -
CHANGE OF PRINCIPAL ADDRESS 2019-11-22 707 JENKS AVE., PANAMA CITY, FL 32405 -
REINSTATEMENT 2019-11-22 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2019-09-27 - -

Documents

Name Date
ANNUAL REPORT 2021-04-30
ANNUAL REPORT 2020-06-23
REINSTATEMENT 2019-11-22
ANNUAL REPORT 2018-04-16
Florida Limited Liability 2017-05-25

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Date of last update: 01 Aug 2025

Sources: Florida Department of State