| Entity Name: | DENTAL SERVICES OF TOWN AND COUNTRY, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 16 May 2011 (14 years ago) |
| Last Event: | ARTICLES OF CORRECTION |
| Event Date Filed: | 20 May 2011 (14 years ago) |
| Document Number: | P11000046547 |
| FEI/EIN Number | 45-2250883 |
| Mail Address: | 5113 NW 93 Doral Way, Doral, FL 33178 |
| Address: | 13776 SW 152 STREET, MIAMI, FL 33177 |
| ZIP code: | 33177 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376823781 | 2011-08-17 | 2011-08-17 | 13776 SW 152ND ST, MIAMI, FL, 331771163, US | 13776 SW 152ND ST, MIAMI, FL, 331771163, US | |||||||||||||||||||||||
|
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| Phone | +1 305-255-8855 |
Authorized person
| Name | DR. ANTONIO OTERO |
| Role | PRESIDENT/OWNER |
| Phone | 3056061232 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN10814 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 077828102 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| OTERO, ANTONIO DDS | Agent | 5113 North West 93 Doral Way, Doral, FL 33178 |
| Name | Role | Address |
|---|---|---|
| OTERO, ANTONIO DDS | President | 5113 NW 93 Doral Way, Doral, FL 33178 |
| Name | Role | Address |
|---|---|---|
| Pena, Alexis Otero, Dr. | director | 5234 NW 94 Doral Place, Doral, FL 33178 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000102345 | OTERO DENTAL CENTERS | ACTIVE | 2018-09-17 | 2028-12-31 | No data | 782 NW 42 AVE, #538, MIAMI, FL, 33126 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2019-04-12 | 13776 SW 152 STREET, MIAMI, FL 33177 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-12 | 5113 North West 93 Doral Way, Doral, FL 33178 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-29 | 13776 SW 152 STREET, MIAMI, FL 33177 | No data |
| ARTICLES OF CORRECTION | 2011-05-20 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-04-23 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-25 |
| ANNUAL REPORT | 2020-06-09 |
| ANNUAL REPORT | 2019-04-12 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-04-03 |
| ANNUAL REPORT | 2016-04-03 |
| ANNUAL REPORT | 2015-04-18 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
