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FLORIDA DENTAL PROFESSIONALS, P.A.

Company Details

Entity Name: FLORIDA DENTAL PROFESSIONALS, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 18 Jul 2013 (12 years ago)
Document Number: P13000060474
FEI/EIN Number 46-3279591
Address: 1200 NETWORK CENTRE DRIVE, SUITE 2, EFFINGHAM, IL, 62401
Mail Address: 1200 NETWORK CENTRE DRIVE, SUITE 2, EFFINGHAM, IL, 62401
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1912757808 2024-03-25 2024-06-27 2220 VENETIAN CT STE 1, NAPLES, FL, 341098726, US 2220 VENETIAN CT STE 1, NAPLES, FL, 341098726, US

Contacts

Phone +1 239-597-4902

Authorized person

Name HILLARY THULL
Role CREDENTIALING COORDINATOR
Phone 2175408946

Taxonomy

Taxonomy Code 1223G0001X - General Practice Dentistry
Is Primary Yes

Agent

Name Role
CORPORATION SERVICE COMPANY Agent

President

Name Role Address
BADGER LEONARD M President 8060 VIA DELLAGIO WAY, SUITE 202, ORLANDO, FL, 32819

Treasurer

Name Role Address
BADGER LEONARD M Treasurer 8060 VIA DELLAGIO WAY, SUITE 202, ORLANDO, FL, 32819

Director

Name Role Address
BADGER LEONARD M Director 8060 VIA DELLAGIO WAY, SUITE 202, ORLANDO, FL, 32819

Secretary

Name Role Address
DORSEY TOMMY Secretary 1200 NETWORK CENTRE DRIVE, EFFINGHAM, IL, 62401

Vice President

Name Role Address
Berger Jacob Vice President 1200 NETWORK CENTRE DRIVE, EFFINGHAM, IL, 62401

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G25000003929 PALM POINTE DENTISTRY ACTIVE 2025-01-09 2030-12-31 No data 1200 NETWORK CENTRE DRIVE, EFFINGHAM, IL, 62401
G24000086461 MASSA DENTAL CENTER ACTIVE 2024-07-19 2029-12-31 No data 1200 NETWORK CENTRE DRIVE, EFFINGHAM, IL, 62401
G24000026585 SOMERSET DENTAL CARE ACTIVE 2024-02-19 2029-12-31 No data 1200 NETWORK CENTRE DR, EFFINGHAM, IL, 62401
G24000004397 DENTISTRY OF FORT MYERS ACTIVE 2024-01-08 2029-12-31 No data 1200 NETWORK CENTRE DRIVE, EFFINGHAM, IL, 62401
G23000094486 SORRENTO EAST DENTAL ACTIVE 2023-08-14 2028-12-31 No data 1200 NETWORK CENTRE DRIVE, EFFINGHAM, IL, 62401
G23000083035 DENTAL CARE & IMPLANTS OF NAPLES ACTIVE 2023-07-14 2028-12-31 No data 1200 NETWORK CENTRE DR, EFFINGHAM, IL, 62401
G23000082549 IMPERIAL DENTAL ACTIVE 2023-07-13 2028-12-31 No data 1200 NETWORK CENTRE DRIVE, EFFINGHAM, IL, 62401
G22000116795 DENTAL SOLUTIONS OF MIAMI ACTIVE 2022-09-16 2027-12-31 No data 1200 NETWORK CENTRE DRIVE, EFFINGHAM, IL, 62401
G22000085705 CERILLO FAMILY DENTISTRY OF TAMPA PALMS ACTIVE 2022-07-20 2027-12-31 No data 1200 NETWORK CENTRE DRIVE, EFFINGHAM, IL, 62401
G22000004613 NORTH RIVER DENTAL ACTIVE 2022-01-13 2027-12-31 No data 1200 NETWORK CENTRE DRIVE, EFFINGHAM, IL, 62401

Documents

Name Date
ANNUAL REPORT 2024-04-25
ANNUAL REPORT 2023-04-05
ANNUAL REPORT 2022-04-26
ANNUAL REPORT 2021-04-29
ANNUAL REPORT 2020-04-28
ANNUAL REPORT 2019-02-28
ANNUAL REPORT 2018-03-21
ANNUAL REPORT 2017-01-10
ANNUAL REPORT 2016-01-07
ANNUAL REPORT 2015-04-02

Date of last update: 02 Feb 2025

Sources: Florida Department of State