| Entity Name: | ARCHETYPE DENTAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 27 Nov 2023 (a year ago) |
| Document Number: | L23000526395 |
| FEI/EIN Number | 99-1157117 |
| Address: | 2240 QUAIL ROOST DR, WESTON, FL 33327 |
| Mail Address: | 2240 QUAIL ROOST DR, WESTON, FL 33327 |
| ZIP code: | 33327 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205668605 | 2024-08-15 | 2024-08-15 | PO BOX 266756, WESTON, FL, 333266756, US | 7663 W SAMPLE RD, CORAL SPRINGS, FL, 330654718, US | |||||||||||||
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| Phone | +1 954-906-3095 |
Authorized person
| Name | DR. MARICEL PEREZ |
| Role | PRESIDENT |
| Phone | 9549063095 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PEREZ, MARICEL J | Agent | 2240 QUAIL ROOST DR, WESTON, FL 33327 |
| Name | Role | Address |
|---|---|---|
| PEREZ, MARICEL J | Manager | 2240 QUAIL ROOST DR, WESTON, FL 33327 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-05 | 2240 QUAIL ROOST DR, WESTON, FL 33327 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-05 | 2240 QUAIL ROOST DR, WESTON, FL 33327 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| Florida Limited Liability | 2023-11-27 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
