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PALM VALLEY FAMILY DENTISTRY, PLLC - Florida Company Profile

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Company Details

Entity Name: PALM VALLEY FAMILY DENTISTRY, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 31 Oct 2024 (10 months ago)
Document Number: L24000463598
FEI/EIN Number 33-1900558
Address: 3791 PALM VALLEY RD., #205, PONTE VEDRA BEACH, FL, 32082
Mail Address: 3791 PALM VALLEY RD., #205, PONTE VEDRA BEACH, FL, 32082
ZIP code: 32082
City: Ponte Vedra Beach
County: St. Johns
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
YODER DAVID Manager 3791 PALM VALLEY RD. #205, PONTE VEDRA BEACH, FL, 32082
YODER DAVID DDS Agent 3791 PALM VALLEY RD., PONTE VEDRA BEACH, FL, 32082
Pucillo Marie Manager 3791 PALM VALLEY RD., PONTE VEDRA BEACH, FL, 32082

National Provider Identifier

NPI Number:
1790500908
Certification Date:
2024-12-03

Authorized Person:

Name:
MCKENZIE WORTEN
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Documents

Name Date
Florida Limited Liability 2024-10-31

USAspending Awards / Financial Assistance

Date:
2020-04-13
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
9000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

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Date of last update: 03 Aug 2025

Sources: Florida Department of State