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DR. KELLI DMD, PA

Company Details

Entity Name: DR. KELLI DMD, PA
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 14 Feb 2018 (7 years ago)
Document Number: P18000015572
FEI/EIN Number 82-4471430
Address: 1729 HERITAGE TRAIL SUITE 904, NAPLES, FL 34112
Mail Address: 1729 HERITAGE TRAIL SUITE 904, NAPLES, FL 34112
ZIP code: 34112
County: Collier
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1992206593 2018-02-28 2018-02-28 1729 HERITAGE TRL # 904, NAPLES, FL, 341127591, US 1729 HERITAGE TRL # 904, NAPLES, FL, 341127591, US

Contacts

Phone +1 239-304-1900
Fax 2393041917

Authorized person

Name DR. KELLI EBERHARDT SALOMON
Role OWNER
Phone 2393041900

Taxonomy

Taxonomy Code 261QD0000X - Dental Clinic/Center
License Number DN22050
State FL
Is Primary Yes

Agent

Name Role
PADLY LAW PA Agent

President

Name Role Address
EBERHARDT SALOMON, KELLI President 10022 BOCA CIRCLE, NAPLES, FL 34109

Documents

Name Date
ANNUAL REPORT 2024-04-15
ANNUAL REPORT 2023-03-02
ANNUAL REPORT 2022-02-21
ANNUAL REPORT 2021-01-27
ANNUAL REPORT 2020-02-24
ANNUAL REPORT 2019-04-30
Domestic Profit 2018-02-14

Date of last update: 18 Jan 2025

Sources: Florida Department of State