| Entity Name: | MORGAN CLAY MORRISON BA, MS, DMD, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Apr 2023 (2 years ago) |
| Document Number: | L23000174403 |
| FEI/EIN Number | 923575176 |
| Address: | 1515 INDIAN RIVER BLVD., SUITE A-140, VERO BEACH, FL, 32960, US |
| Mail Address: | 1515 INDIAN RIVER BLVD., SUITE A-140, VERO BEACH, FL, 32960, US |
| ZIP code: | 32960 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164249157 | 2024-09-23 | 2024-09-23 | 1515 INDIAN RIVER BLVD STE A140, VERO BEACH, FL, 329607106, US | 1515 INDIAN RIVER BLVD STE A140, VERO BEACH, FL, 329607106, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 772-770-2225 |
| Fax | 7727706062 |
Authorized person
| Name | DR. MORGAN CLAY MORRISON |
| Role | OWNER |
| Phone | 7727702225 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MORGAN CLAY MORRISON PROVIDER NPI NUMBER |
| Number | 1164952792 |
| Issuer | CARL JEFFREY CLAY PROVIDER NPI NUMBER |
| Number | 1457394447 |
| Issuer | CARL JEFFREY CLAY DENTAL LICENSE |
| Number | DN20140 |
| State | FL |
| Issuer | MORGAN CLAY MORRISON DENTAL LICENSE |
| Number | DN22738 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MORGAN CLAY MORRISON, DMD, PLLC PROFIT SHARING PLAN | 2023 | 923575176 | 2024-04-25 | MORGAN CLAY MORRISON, BA, MS, DMD, PLLC | 7 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-04-25 |
| Name of individual signing | MORGAN MORRISON |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-04-25 |
| Name of individual signing | MORGAN MORRISON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| MORRISON MORGAN C | Agent | 1515 INDIAN RIVER BLVD., VERO BEACH, FL, 32960 |
| Name | Role | Address |
|---|---|---|
| MORRISON MORGAN C | Manager | 1515 INDIAN RIVER BLVD., SUITE A-140, VERO BEACH, FL, 32960 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000075644 | VERO BEACH DENTAL CARE | ACTIVE | 2023-06-23 | 2028-12-31 | No data | 1515 INDIAN RIVER BLVD SUITE A-140, VERO BEACH, FL, 32960 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| Florida Limited Liability | 2023-04-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
