| Entity Name: | BLUEWATER BAY DENTAL, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 06 Feb 2001 (24 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 14 Aug 2008 (17 years ago) |
| Document Number: | P01000014272 |
| FEI/EIN Number | 593696410 |
| Address: | 4400 EAST HIGHWAY 20, SUITE 101, MERCHANT'S WALK, NICEVILLE, FL, 32578 |
| Mail Address: | 4400 EAST HIGHWAY 20, SUITE 101, MERCHANT'S WALK, NICEVILLE, FL, 32578 |
| ZIP code: | 32578 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SMILEOLOGY 401(K) PLAN | 2023 | 593696410 | 2024-09-23 | BLUEWATER BAY DENTAL, P.A. | 27 | |||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2024-09-23 |
| Name of individual signing | MICHAEL VANDERFORD |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2016-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 8508974488 |
| Plan sponsor’s address | 4400 E HIGHWAY 20, NICEVILLE, FL, 32578 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-07 |
| Name of individual signing | MICHAEL VANDERFORD |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2016-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 8508974488 |
| Plan sponsor’s address | 4400 E HIGHWAY 20, NICEVILLE, FL, 32578 |
Signature of
| Role | Plan administrator |
| Date | 2022-09-20 |
| Name of individual signing | LOVELYN SILVA |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| BROUTIN OLIVIER | Agent | 4400 EAST HIGHWAY 20, NICEVILLE, FL, 32578 |
| Name | Role | Address |
|---|---|---|
| BROUTIN OLIVIER | Director | 4400 E. HWY. 20, STE. 101, MERCHANT'S WALK, NICEVILLE, FL, 32578 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000064696 | SMILEOLOGY | ACTIVE | 2022-05-25 | 2027-12-31 | No data | 4400 EAST HIGHWAY 20,SUITE 101, NICEVILLE, FL, 32578 |
| G19000068283 | SMILEOLOGY | EXPIRED | 2019-06-17 | 2024-12-31 | No data | 4400 EAST HIGHWAY 20, SUITE 101, NICEVILLE, FL, 32578 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 2008-08-14 | BLUEWATER BAY DENTAL, P.A. | No data |
| NAME CHANGE AMENDMENT | 2005-02-03 | BROUTIN INSTITUTE FOR AESTHETIC DENTISTRY, P.A. | No data |
| CANCEL ADM DISS/REV | 2003-11-12 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2002-11-06 | BROUTIN, OLIVIER | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2002-11-06 | 4400 EAST HIGHWAY 20, SUITE 101, NICEVILLE, FL 32578 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-12 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-02-18 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-01-08 |
| ANNUAL REPORT | 2018-01-10 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-07-07 |
| ANNUAL REPORT | 2015-01-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
