| Entity Name: | PALM HARBOR PREMIER DENTAL INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 11 Jun 2018 (7 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | P18000052357 |
| FEI/EIN Number | 83-0838228 |
| Mail Address: | 3231 WEST PARKLAND BLVD, TAMPA, FL, 33609, US |
| Address: | 30685 US HWY 19 NORTH, PALM HARBOR, FL, 34684 |
| ZIP code: | 34684 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346981610 | 2022-04-02 | 2022-04-02 | 30685 US HIGHWAY 19 N, PALM HARBOR, FL, 346844410, US | 30685 US HIGHWAY 19 N, PALM HARBOR, FL, 346844410, US | |||||||||||||||||||||||||||
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| Phone | +1 727-249-0460 |
| Fax | 7272166627 |
Authorized person
| Name | DR. DAVID L CASTELLANO |
| Role | DENTIST/VICE-PRESIDENT |
| Phone | 7272490460 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE DENTAL LICENSE |
| Number | DN15383 |
| State | FL |
| Issuer | STATE DENTAL LICENSE |
| Number | DN17378 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CANNARIATO JOHN M | Agent | 3231 WEST PARKLAND BLVD, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| CANNARIATO JOHN M | President | 3231 WEST PARKLAND BLVD, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| CASTELLANO DAVID | Vice President | 4115 WEST TACON ST, TAMPA,, FL, 33629 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-05-04 |
| ANNUAL REPORT | 2020-06-23 |
| ANNUAL REPORT | 2019-04-30 |
| Domestic Profit | 2018-06-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
