| Entity Name: | BWM DENTAL HOLDINGS, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 22 Jan 2024 (a year ago) |
| Document Number: | L24000041469 |
| Address: | 1415 GOVERNORS SQUARE, TALLAHASSEE, FL 32301 |
| Mail Address: | 1415 GOVERNORS SQUARE, TALLAHASSEE, FL 32301 |
| ZIP code: | 32301 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821838772 | 2024-05-29 | 2024-05-29 | PO BOX 70887, CLEVELAND, OH, 441900887, US | 15450 PANAMA CITY BEACH PKWY, PANAMA CITY BEACH, FL, 324135408, US | |||||||||||||
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| Phone | +1 850-238-3326 |
Authorized person
| Name | VALERIE HAMILTON |
| Role | DIRECTOR, PROVIDER STRATEGY |
| Phone | 3154105531 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role |
|---|---|
| DFS AGENT, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| MECKELBERG, BRANDON | Manager | 305 PELICAN CIR, INLET BEACH, FL 32461 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000067647 | ASPEN DENTAL | ACTIVE | 2024-05-29 | 2029-12-31 | No data | 281 SANDERS CREEK PARKWAY, EAST SYRACUSE, NY, 13057 |
| G24000067657 | ASPEN DENTAL | ACTIVE | 2024-05-29 | 2029-12-31 | No data | 281 SANDERS CREEK PARKWAY, EAST SYRACUSE, NY, 13057 |
| G24000067661 | ASPEN DENTAL | ACTIVE | 2024-05-29 | 2029-12-31 | No data | 281 SANDERS CREEK PARKWAY, EAST SYRACUSE, NY, 13057 |
| G24000067670 | ASPEN DENTAL | ACTIVE | 2024-05-29 | 2029-12-31 | No data | 281 SANDERS CREEK PARKWAY, EAST SYRACUSE, NY, 13057 |
| G24000067678 | ASPEN DENTAL | ACTIVE | 2024-05-29 | 2029-12-31 | No data | 281 SANDERS CREEK PARKWAY, EAST SYRACUSE, NY, 13057 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-01-22 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
