| Entity Name: | ACOSTA DENTAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Jul 2021 (4 years ago) |
| Document Number: | L21000325828 |
| FEI/EIN Number | 87-1853615 |
| Address: | 445 SW SILVERPALM DRIVE, LAKE CITY, FL, 32024, US |
| Mail Address: | 445 SW SILVERPALM DRIVE, LAKE CITY, FL, 32024, US |
| ZIP code: | 32024 |
| County: | Columbia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982454310 | 2024-03-26 | 2024-06-05 | PO BOX 70887, CLEVELAND, OH, 441900887, US | 2143 W US HIGHWAY 90 STE A, LAKE CITY, FL, 320557726, US | |||||||||||||||
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| Phone | +1 386-243-2031 |
| Fax | 3867550132 |
Authorized person
| Name | VALERIE HAMILTON |
| Role | DIRECTOR OF CONTRACTING |
| Phone | 3154546000 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role |
|---|---|
| DFS AGENT, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| ACOSTA MANUEL DR. | Manager | 445 SW SILVERPALM DR, LAKE CITY, FL, 32024 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000041082 | ASPEN DENTAL | ACTIVE | 2024-03-22 | 2029-12-31 | No data | 281 SANDERS CREEK PARKWAY, EAST SYRACUSE, NY, 13057 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-03-04 |
| ANNUAL REPORT | 2022-02-05 |
| Florida Limited Liability | 2021-07-16 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
