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. |
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 |
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 | |||||||||||||||||||
|
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 |
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 |
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 | - |
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