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GREAT FLORIDA SMILES & ORTHODONTICS PCB, PLLC - Florida Company Profile

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Company Details

Entity Name: GREAT FLORIDA SMILES & ORTHODONTICS PCB, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 27 Jun 2023 (2 years ago)
Document Number: L23000308221
FEI/EIN Number 93-2122500
Mail Address: 755 GRAND BLVD, SUITE 105B 285, MIRAMAR BEACH, FL, 32550, US
Address: 6757 US HIGHWAY 98, SANTA ROSA BEACH, FL, 32459, US
ZIP code: 32459
City: Santa Rosa Beach
County: Walton
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
- Agent -
O'DONNELL MICHAEL T Manager 755 GRAND BLVD, SUITE 105B 285, MIRAMAR BEACH, FL, 32550

National Provider Identifier

NPI Number:
1750068482
Certification Date:
2023-07-04

Authorized Person:

Name:
MICHAEL O'DONNELL
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
122300000X - Dentist
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G23000098122 EMERALD COAST DENTAL SPA ACTIVE 2023-08-22 2028-12-31 - 6757 US HIGHWAY 98, SANTA ROSA BEACH, FL, 32459

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-04-15 Barker Williams, PLLC -
REGISTERED AGENT ADDRESS CHANGED 2024-04-15 60 Clayton Lane, Santa Rosa Beach, FL 32459 -

Documents

Name Date
ANNUAL REPORT 2024-04-15
Florida Limited Liability 2023-06-27

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Date of last update: 01 Aug 2025

Sources: Florida Department of State