| Entity Name: | SEABREEZE ENDODONTICS, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 11 May 2018 (7 years ago) |
| Document Number: | P18000043930 |
| FEI/EIN Number | 83-0712086 |
| Address: | 4579 E. Hwy 20, Suite 220, Niceville, FL 32578 |
| Mail Address: | 4579 E. Hwy 20, Suite 220, Niceville, FL 32578 |
| ZIP code: | 32578 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457914129 | 2019-04-18 | 2019-04-18 | 4579 E HIGHWAY 20 STE 220, NICEVILLE, FL, 325789808, US | 4579 E HIGHWAY 20 STE 220, NICEVILLE, FL, 325789808, US | |||||||||||||
|
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| Phone | +1 850-424-7368 |
Authorized person
| Name | DR. SHANE ROBERT HANSON |
| Role | PRESIDENT |
| Phone | 8504247368 |
Taxonomy
| Taxonomy Code | 1223E0200X - Endodontist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Hanson, Shane, DMD | President | 4579 E. Hwy 20, Suite 220 Niceville, FL 32578 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000061994 | JACKSONVILLE DENTAL SPECIALISTS | ACTIVE | 2023-05-17 | 2028-12-31 | No data | 11512 LAKE MEAD AVENUE, BUILDING 532, JACKSONVILLE, FL, 32256 |
| G23000014659 | GERIC ENDODONTICS | ACTIVE | 2023-01-31 | 2028-12-31 | No data | 4788 HODGES BLVD SUITE 208, JACKSONVILLE, FL, 32224 |
| G23000008470 | GERIC ENDODONTICS | ACTIVE | 2023-01-19 | 2028-12-31 | No data | 4788 HODGES BLVD SUITE 208, JACKSONVILLE, FL, 32224 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-03 | 4579 E. Hwy 20, Suite 220, Niceville, FL 32578 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-03 | 4579 E. Hwy 20, Suite 220, Niceville, FL 32578 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-08-01 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-08-01 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| Reg. Agent Change | 2023-08-01 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-05-29 |
| ANNUAL REPORT | 2019-04-19 |
| Domestic Profit | 2018-05-11 |
Date of last update: 17 Feb 2025
Sources: Florida Department of State
