| Entity Name: | HUNTERS CREEK DENTISTRY, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 01 Feb 2021 (4 years ago) |
| Document Number: | L21000054610 |
| FEI/EIN Number | 86-1864596 |
| Mail Address: | 3221 CONWAY RD, STE D, ORLANDO, FL 32812 |
| Address: | 14009 EGRET TOWER DR, ORLANDO, FL 32837 |
| ZIP code: | 32837 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861085094 | 2021-02-18 | 2021-02-18 | 14009 EGRET TOWER DR, ORLANDO, FL, 328376197, US | 14009 EGRET TOWER DR, ORLANDO, FL, 328376197, US | |||||||||||||||||||
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| Phone | +1 407-251-5100 |
Authorized person
| Name | MR. PETER KELLY |
| Role | OWNER |
| Phone | 4104103031 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE LICENSE |
| Number | DN19430 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROBINSON, MATTHEW | Agent | 3221 CONWAY RD, STE D, ORLANDO, FL 32812 |
| Name | Role | Address |
|---|---|---|
| KELLY, PETER | Manager | 3221 CONWAY RD STE D, ORLANDO, FL 32812 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-30 | 14009 EGRET TOWER DR, ORLANDO, FL 32837 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-15 |
| ANNUAL REPORT | 2023-02-24 |
| ANNUAL REPORT | 2022-01-30 |
| Florida Limited Liability | 2021-02-01 |
Date of last update: 14 Jan 2025
Sources: Florida Department of State
