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  5. BLAKE E. MOORES, D.D.S., P.A.

BLAKE E. MOORES, D.D.S., P.A.

Company Details

Entity Name: BLAKE E. MOORES, D.D.S., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 08 Dec 2004 (20 years ago)
Date of dissolution: 25 Sep 2015 (9 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 25 Sep 2015 (9 years ago)
Document Number: P04000165025
FEI/EIN Number 202066390
Address: 1831 N. BELCHER ROAD, SUITE F-3, CLEARWATER, FL, 33765
Mail Address: 840 CYPRESS LAKES BLVD., TARPON SPRINGS, FL, 34688
ZIP code: 33765
County: Pinellas
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLAKE E. MOORES, D.D.S., P.A. 401(K) PLAN 2014 202066390 2015-08-04 BLAKE E. MOORES, D.D.S., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 7277918823
Plan sponsor’s address 1831 NORTH BELCHER ROAD, SUITE F-3, CLEARWATER, FL, 33765

Signature of
Role Plan administrator
Date 2015-08-04
Name of individual signing BLAKE MOORES
Valid signature Filed with authorized/valid electronic signature
BLAKE E. MOORES, D.D.S., P.A. 401(K) PLAN 2013 202066390 2014-09-17 BLAKE E. MOORES, D.D.S., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 7277918823
Plan sponsor’s address 1831 NORTH BELCHER ROAD, SUITE F-3, CLEARWATER, FL, 33765

Signature of
Role Plan administrator
Date 2014-09-16
Name of individual signing BLAKE MOORES
Valid signature Filed with authorized/valid electronic signature
BLAKE E. MOORES, D.D.S., P.A. 401(K) PLAN 2012 202066390 2013-06-10 BLAKE E. MOORES, D.D.S., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 7277918823
Plan sponsor’s address 1831 NORTH BELCHER ROAD, SUITE F-3, CLEARWATER, FL, 33765

Signature of
Role Plan administrator
Date 2013-06-10
Name of individual signing BLAKE MOORES
Valid signature Filed with authorized/valid electronic signature
BLAKE E. MOORES, D.D.S., P.A. 401(K) PLAN 2011 202066390 2012-09-14 BLAKE E. MOORES, D.D.S., P.A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 7277918823
Plan sponsor’s address 1831 NORTH BELCHER ROAD, SUITE F-3, CLEARWATER, FL, 33765

Plan administrator’s name and address
Administrator’s EIN 202066390
Plan administrator’s name BLAKE E. MOORES, D.D.S., P.A.
Plan administrator’s address 1831 NORTH BELCHER ROAD, SUITE F-3, CLEARWATER, FL, 33765
Administrator’s telephone number 7277918823

Signature of
Role Plan administrator
Date 2012-09-14
Name of individual signing BLAKE MOORES
Valid signature Filed with authorized/valid electronic signature
BLAKE E. MOORES, D.D.S., P.A. 401(K) PLAN 2010 202066390 2011-09-15 BLAKE E. MOORES, D.D.S., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 7277918823
Plan sponsor’s address 1831 NORTH BELCHER ROAD, SUITE F-3, CLEARWATER, FL, 33765

Plan administrator’s name and address
Administrator’s EIN 202066390
Plan administrator’s name BLAKE E. MOORES, D.D.S., P.A.
Plan administrator’s address 1831 NORTH BELCHER ROAD, SUITE F-3, CLEARWATER, FL, 33765
Administrator’s telephone number 7277918823

Signature of
Role Plan administrator
Date 2011-09-14
Name of individual signing BLAKE MOORES
Valid signature Filed with authorized/valid electronic signature
BLAKE E. MOORES, D.D.S., P.A. 401(K) PLAN 2009 202066390 2010-10-14 BLAKE E. MOORES, D.D.S., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 7277918823
Plan sponsor’s address 1831 NORTH BELCHER ROAD, SUITE F-3, CLEARWATER, FL, 33765

Plan administrator’s name and address
Administrator’s EIN 202066390
Plan administrator’s name BLAKE E. MOORES, D.D.S., P.A.
Plan administrator’s address 1831 NORTH BELCHER ROAD, SUITE F-3, CLEARWATER, FL, 33765
Administrator’s telephone number 7277918823

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing BLAKE MOORES
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MOORES BLAKE E Agent 1831 N. BELCHER ROAD, CLEARWATER, FL, 33765

President

Name Role Address
MOORES BLAKE E President 1831 N. BELCHER RD., SUITE F-3, CLEARWATER, FL, 33765

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2015-09-25 No data No data
CHANGE OF MAILING ADDRESS 2005-02-18 1831 N. BELCHER ROAD, SUITE F-3, CLEARWATER, FL 33765 No data

Documents

Name Date
ANNUAL REPORT 2014-01-10
ANNUAL REPORT 2013-01-30
ANNUAL REPORT 2012-01-05
ANNUAL REPORT 2011-01-21
ANNUAL REPORT 2010-01-07
ANNUAL REPORT 2009-04-16
ANNUAL REPORT 2008-04-21
ANNUAL REPORT 2007-04-25
ANNUAL REPORT 2006-04-24
ANNUAL REPORT 2005-02-18

Related by officers

MOORES BLAKE E

BLAKE E. MOORES, LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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