| Entity Name: | ROYAL PALM DENTAL ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 16 Aug 1990 (34 years ago) |
| Document Number: | L93897 |
| FEI/EIN Number | 650214386 |
| Address: | 11358 OKEECHOBEE BLVD, SUITE 1, ROYAL PALM BEACH, FL, 33411, US |
| Mail Address: | 11358 OKEECHOBEE BLVD, SUITE 1, ROYAL PALM BEACH, FL, 33411, US |
| ZIP code: | 33411 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336298017 | 2007-01-10 | 2020-08-22 | 11358 OKEECHOBEE BLVD, SUITE 1, ROYAL PALM BEACH, FL, 334118723, US | 11358 OKEECHOBEE BLVD, SUITE 1, ROYAL PALM BEACH, FL, 334118723, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 561-790-0177 |
| Fax | 5617905291 |
Authorized person
| Name | DR. DAVID GOLDBERG |
| Role | PRESIDENT |
| Phone | 5617900177 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN10503 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MORAGUEZ IVO DR | Agent | 11358 OKEECHOBEE BLVD., ROYAL PALM BEACH, FL, 33411 |
| Name | Role | Address |
|---|---|---|
| MORAGUEZ IVO | President | 565 NO. COUNTY CLUB DRIVE, ATLANTIS, FL, 33462 |
| Name | Role | Address |
|---|---|---|
| MORAGUEZ MICHAEL R | Secretary | 11358 OKEECHOBEE BLVD, ROYAL PALM BEACH, FL, 33411 |
| Name | Role | Address |
|---|---|---|
| MORAGUEZ ISABEL | Vice President | 11358 OKEECHOBEE BLVD, ROYAL PALM BEACH, FL, 33411 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2019-11-22 | No data | No data |
| AMENDMENT | 2019-09-30 | No data | No data |
| AMENDMENT AND NAME CHANGE | 1996-02-26 | ROYAL PALM DENTAL ASSOCIATES, P.A. | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
