| Entity Name: | TIOGA DENTAL & ORTHODONTICS, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Oct 2017 (7 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 02 May 2024 (9 months ago) |
| Document Number: | L17000217138 |
| FEI/EIN Number | 82-3155434 |
| Mail Address: | 6240 LAKE OSPREY DRIVE, SARASOTA, FL, 34240 |
| Address: | 13005 S.W. 1ST ROAD, SUITE 233, GAINESVILLE, FL, 32669 |
| ZIP code: | 32669 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881198299 | 2018-03-20 | 2018-03-20 | 13005 SW 1ST RD STE 233, GAINESVILLE, FL, 326693266, US | 13005 SW 1ST RD STE 233, GAINESVILLE, FL, 326693266, US | |||||||||||||
|
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| Phone | +1 352-333-1946 |
Authorized person
| Name | STEPHANIE GOMEZ |
| Role | CREDENTIALING SUPERVISOR |
| Phone | 3052742499 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| GALLO DONALD ADMD | Manager | 6240 LAKE OSPREY DRIVE, SARASOTA, FL, 34240 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000119858 | TIOGA DENTAL & ORTHODONTICS | EXPIRED | 2017-10-31 | 2022-12-31 | No data | 13005 S.W. 1ST ROAD, SUITE 233, GAINESVILLE, FL, 32669 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2024-05-02 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-05-02 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-05-02 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-07-24 |
| CORLCRACHG | 2024-05-02 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-19 |
| ANNUAL REPORT | 2018-04-27 |
| Florida Limited Liability | 2017-10-19 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
