| Entity Name: | DENTAL OFFICE OF PALM HARBOR, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Jan 2017 (8 years ago) |
| Document Number: | P17000000775 |
| FEI/EIN Number | 81-4888395 |
| Address: | 3438 TAMPA RD, STE. 11, PALM HARBOR, FL, 34684 |
| Mail Address: | 1044 BELCHER RD., DUNEDIN, FL, 34698 |
| ZIP code: | 34684 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023584174 | 2018-10-16 | 2018-10-16 | 3438 TAMPA RD STE 11, PALM HARBOR, FL, 346843530, US | 3438 TAMPA RD STE 11, PALM HARBOR, FL, 346843530, US | |||||||||||||||
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| Phone | +1 727-786-1077 |
| Fax | 7277812131 |
Authorized person
| Name | NIKKI BLANTON |
| Role | OFFICE ADMINSTRATION |
| Phone | 7277388845 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LYONS GARY W | Agent | 311 S. MISSOURI AVE., CLEARWATER, FL, 33756 |
| Name | Role | Address |
|---|---|---|
| SCHERER KENNETH R | Director | 1856 BARCELONA DR., DUNEDIN, FL, 34698 |
| JACKSON SANJIE | Director | 12111 Rustic River W., Tampa, FL, 33635 |
| Name | Role | Address |
|---|---|---|
| SCHERER KENNETH R | President | 1856 BARCELONA DR., DUNEDIN, FL, 34698 |
| Name | Role | Address |
|---|---|---|
| SCHERER KENNETH R | Treasurer | 1856 BARCELONA DR., DUNEDIN, FL, 34698 |
| Name | Role | Address |
|---|---|---|
| JACKSON SANJIE | Vice President | 12111 Rustic River W., Tampa, FL, 33635 |
| Name | Role | Address |
|---|---|---|
| JACKSON SANJIE | Secretary | 12111 Rustic River W., Tampa, FL, 33635 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-02-13 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-03-10 |
| ANNUAL REPORT | 2018-04-27 |
| Domestic Profit | 2017-01-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
