| Entity Name: | THE SMILE MISSION LAKELAND PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Aug 2023 (a year ago) |
| Document Number: | L23000380599 |
| FEI/EIN Number | 93-2917391 |
| Mail Address: | 9900 SW 168TH ST, MIAMI, FL, 33157, US |
| Address: | 3615 FLORIDA AVE S, 101230 MERCHANTS WALK, LAKELAND, FL, 33803, US |
| ZIP code: | 33803 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740058072 | 2023-12-15 | 2023-12-15 | 9900 SW 168TH ST, MIAMI, FL, 331574378, US | 3615 S FLORIDA AVE STE 7, LAKELAND, FL, 338034876, US | |||||||||||||
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| Phone | +1 786-701-8246 |
Authorized person
| Name | DUSTIN PFUNDHELLER |
| Role | MANAGER |
| Phone | 7867018246 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PFUNDHELLER DUSTIN M | Agent | 9900 SW 168TH ST, MIAMI, FL, 33157 |
| Name | Role | Address |
|---|---|---|
| PFUNDHELLER DUSTIN M | Manager | 9900 SW 168TH ST, MIAMI, FL, 33157 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| Florida Limited Liability | 2023-08-14 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
