| Entity Name: | SHORELINE DENTAL STUDIO PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 12 Aug 2021 (4 years ago) |
| Document Number: | L21000363307 |
| FEI/EIN Number | 87-2173226 |
| Address: | 34 Walter Martin Road NE, FORT WALTON BEACH, FL 32548 |
| Mail Address: | 34 Walter Martin Road NE, FORT WALTON BEACH, FL 32548 |
| ZIP code: | 32548 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750049417 | 2021-11-30 | 2021-11-30 | 4 OKAHATCHEE CIR SE, FORT WALTON BEACH, FL, 325485711, US | 34 WALTER MARTIN RD NE, FORT WALTON BEACH, FL, 325484960, US | |||||||||||||
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| Phone | +1 760-528-0275 |
Authorized person
| Name | DR. ASHLEY DUBOIS |
| Role | OWNER/MEMBER |
| Phone | 7605280275 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DUBOIS, ASHLEY M, DDS | Agent | 34 Walter Martin Road NE, FORT WALTON BEACH, FL 32548 |
| Name | Role | Address |
|---|---|---|
| DUBOIS, ASHLEY M, DDS | Authorized Member | 34 Walter Martin Road NE, FORT WALTON BEACH, FL 32548 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000026073 | SHORELINE DENTAL STUDIO | ACTIVE | 2022-01-31 | 2027-12-31 | No data | 34 WALTER MARTIN ROAD NE, FORT WALTON BEACH, FL, 32548 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-02-17 | 34 Walter Martin Road NE, FORT WALTON BEACH, FL 32548 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-17 | 34 Walter Martin Road NE, FORT WALTON BEACH, FL 32548 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-27 | 34 Walter Martin Road NE, FORT WALTON BEACH, FL 32548 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-17 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-01-25 |
| Florida Limited Liability | 2021-08-12 |
Date of last update: 13 Feb 2025
Sources: Florida Department of State
