| Entity Name: | DENTAL SPECIALISTS OF BROWARD GROUP CO. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 01 Feb 2013 (12 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 14 Sep 2017 (7 years ago) |
| Document Number: | P13000011085 |
| FEI/EIN Number | 46-1915194 |
| Address: | 1009 w state rd 84, Fort Lauderdale, FL 33315 |
| Mail Address: | 1009 w state rd 84, Fort Lauderdale, FL 33315 |
| ZIP code: | 33315 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346674967 | 2013-08-30 | 2016-07-20 | 9 SW 17TH ST, FT LAUDERDALE, FL, 333151741, US | 9 SW 17TH ST, FT LAUDERDALE, FL, 333151741, US | |||||||||||||||||||
|
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| Phone | +1 954-588-4671 |
| Fax | 3055936855 |
Authorized person
| Name | DR. GARY L GOLDEN |
| Role | CLINICAL DIRECTOR / OWNER |
| Phone | 9545884671 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN 2046 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PELTON, IVAN S, DDS | Agent | 1009 w state rd 84, Fort Lauderdale, FL 33315 |
| Name | Role | Address |
|---|---|---|
| Pelton, Ivan S, DDS | Ivan s pelton | 1009 w state rd 84, Fort Lauderdale, FL 33315 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-24 | 1009 w state rd 84, Fort Lauderdale, FL 33315 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-24 | 1009 w state rd 84, Fort Lauderdale, FL 33315 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-24 | 1009 w state rd 84, Fort Lauderdale, FL 33315 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-09-14 | PELTON, IVAN S, DDS | No data |
| AMENDMENT | 2017-09-14 | No data | No data |
| AMENDMENT | 2014-02-07 | No data | No data |
| AMENDMENT | 2013-12-12 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-24 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-04-12 |
| ANNUAL REPORT | 2020-04-08 |
| ANNUAL REPORT | 2019-02-21 |
| ANNUAL REPORT | 2018-01-22 |
| Amendment | 2017-09-14 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-01-18 |
Date of last update: 22 Feb 2025
Sources: Florida Department of State
