| Entity Name: | MY FAVORITE DENTAL BOUTIQUE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 27 Nov 2023 (a year ago) |
| Document Number: | L23000528378 |
| FEI/EIN Number | 93-4713572 |
| Address: | 1670 S US HWY 17-92, LONGWOOD, FL 32750 UN |
| Mail Address: | 1650 IMPERIAL PALM DR, APOPKA, FL 32712 UN |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255182515 | 2024-03-27 | 2024-03-27 | 1670 S US HIGHWAY 17 92, LONGWOOD, FL, 327506516, US | 1670 S US HIGHWAY 17 92, LONGWOOD, FL, 327506516, US | |||||||||||||
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| Phone | +1 407-274-4744 |
Authorized person
| Name | PAULA GRISALES CANO |
| Role | OWNER |
| Phone | 4072744744 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CARMONA, JUAN C | Agent | 1650 IMPERIAL PALM DR, APOPKA, FL 32712 |
| Name | Role | Address |
|---|---|---|
| GRISALES, PAULA A, DR. | Authorized Member | 1650 IMPERIAL PALM DR, APOPKA, FL 32712 UN |
| Name | Role | Address |
|---|---|---|
| CARMONA, JUAN C, DR. | Manager | 1650 IMPERIAL PALM DR, APOPKA, FL 32712 UN |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| Florida Limited Liability | 2023-11-27 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
