| Entity Name: | BOYNTON LAKES DENTAL, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Aug 2015 (9 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 03 Apr 2020 (5 years ago) |
| Document Number: | P15000071270 |
| FEI/EIN Number | 65-0504538 |
| Address: | 6609 FOREST HILL BLVD, GREENACRES, FL, 33413, US |
| Mail Address: | 6609 FOREST HILL BLVD, GREENACRES, FL, 33413, US |
| ZIP code: | 33413 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770754111 | 2008-03-13 | 2016-07-21 | 6099 FOREST HILL BLVD, GREENACRES, FL, 33413, US | 6609 FOREST HILL BLVD, GREENACRES, FL, 334133303, US | |||||||||||||||||||||||||
|
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| Phone | +1 561-964-2002 |
| Fax | 5619649606 |
Authorized person
| Name | DR. THOMAS SAITTA |
| Role | DENTIST/OWNER |
| Phone | 5619642002 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN0011357 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | DENTAL OFFICE |
| Number | DN0011357 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SAITTA THOMAS A | Agent | 6609 FOREST HILL BLVD, GREENACRES, FL, 33413 |
| Name | Role | Address |
|---|---|---|
| SAITTA THOMAS A | President | 6609 FOREST HILL BLVD, GREENACRES, FL, 33413 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000044996 | CROWN DENTISTRY OF THE PALM BEACHES | ACTIVE | 2021-04-01 | 2026-12-31 | No data | 6609, FOREST HILL BLVD, GREENACRES, FL, 33413 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2020-04-03 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-04-03 | SAITTA, THOMAS A | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-04-07 | 6609 FOREST HILL BLVD, GREENACRES, FL 33413 | No data |
| CHANGE OF MAILING ADDRESS | 2016-04-07 | 6609 FOREST HILL BLVD, GREENACRES, FL 33413 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-07 | 6609 FOREST HILL BLVD, GREENACRES, FL 33413 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-29 |
| ANNUAL REPORT | 2023-04-13 |
| ANNUAL REPORT | 2022-05-01 |
| ANNUAL REPORT | 2021-04-01 |
| REINSTATEMENT | 2020-04-03 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-04-07 |
| Domestic Profit | 2015-08-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
