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MODERN DENTAL CAPE CORAL, PLLC - Florida Company Profile

Company Details

Entity Name: MODERN DENTAL CAPE CORAL, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

MODERN DENTAL CAPE CORAL, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 14 Nov 2019 (5 years ago)
Document Number: L19000276173
FEI/EIN Number 84-3741387

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 706 SW Pine Island Road, CAPE CORAL, FL, 33991, US
Mail Address: 706 SW Pine Island Road, Suite 103, Cape Coral, FL, 33991, US
ZIP code: 33991
County: Lee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1437785847 2020-03-17 2020-03-17 14575 TAMIAMI TRL STE A, NORTH PORT, FL, 342872743, US 706 SW PINE ISLAND RD, SUITE 103, CAPE CORAL, FL, 33991, US

Contacts

Phone +1 941-888-2362
Phone +1 941-610-6200

Authorized person

Name TYLER M BLACKENBURG
Role PERIODONTIST
Phone 9547367924

Taxonomy

Taxonomy Code 1223G0001X - General Practice Dentistry
Is Primary Yes
Taxonomy Code 1223P0300X - Periodontist
Is Primary No

Key Officers & Management

Name Role Address
PETTE GREGORY A Authorized Manager 706 SW Pine Island Road, Cape Coral, FL, 33991
ELIOPOULOS LUCAS G Authorized Manager 706 SW Pine Island Road, CAPE CORAL, FL, 33991
PETTE GREGORY A Agent 706 SW Pine Island Road, Cape Coral, FL, 33991

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2021-04-01 706 SW Pine Island Road, Suites 103/104, CAPE CORAL, FL 33991 -
CHANGE OF MAILING ADDRESS 2021-04-01 706 SW Pine Island Road, Suites 103/104, CAPE CORAL, FL 33991 -
REGISTERED AGENT ADDRESS CHANGED 2021-04-01 706 SW Pine Island Road, Suite 103, Cape Coral, FL 33991 -

Documents

Name Date
ANNUAL REPORT 2024-01-11
ANNUAL REPORT 2023-01-10
ANNUAL REPORT 2022-04-21
AMENDED ANNUAL REPORT 2021-04-01
ANNUAL REPORT 2021-01-04
AMENDED ANNUAL REPORT 2020-06-17
ANNUAL REPORT 2020-01-02
Florida Limited Liability 2019-11-14

Date of last update: 01 Mar 2025

Sources: Florida Department of State