| Entity Name: | NORTH TAMPA DENTAL, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 21 May 2015 (10 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | P15000045983 |
| FEI/EIN Number | 47-4085619 |
| Address: | 10549 N. FLORIDA AVE., SUITE E, TAMPA, FL, 33612, US |
| Mail Address: | 14115 RIVERSTONE DR., TAMPA, FL, 33624, US |
| ZIP code: | 33612 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154700755 | 2015-05-28 | 2015-05-28 | 14115 RIVERSTONE DR, TAMPA, FL, 336246932, US | 10549 N FLORIDA AVE, SUITE E, TAMPA, FL, 336126707, US | |||||||||||||||||
|
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| Phone | +1 813-935-3129 |
Authorized person
| Name | DR. RALPH W FORTSON |
| Role | PRESIDENT |
| Phone | 8139681170 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN10042 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FORTSON RALPH W | Agent | 14115 RIVERSTONE DR., TAMPA, FL, 33624 |
| Name | Role | Address |
|---|---|---|
| FORTSON, D.D.S. RALPH W | President | 14115 RIVERSTONE DR., TAMPA, FL, 33624 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-01-11 | FORTSON, RALPH W | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-02-21 |
| Domestic Profit | 2015-05-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
