| Entity Name: | SUSAN PRATER KUDLATS, D.M.D, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 26 Sep 2018 (6 years ago) |
| Document Number: | P18000081496 |
| FEI/EIN Number | 83-2328168 |
| Address: | 221 SPANISH CREEK DRIVE, PONTE VEDRA, FL, 32081 |
| Mail Address: | 221 SPANISH CREEK DRIVE, PONTE VEDRA, FL, 32081 |
| ZIP code: | 32081 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487123006 | 2018-11-14 | 2018-11-14 | 12620 BEACH BLVD STE 18, JACKSONVILLE, FL, 322467130, US | 12620 BEACH BLVD STE 18, JACKSONVILLE, FL, 322467130, US | |||||||||||||
|
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| Phone | +1 404-509-1292 |
Authorized person
| Name | SUSAN PRATER |
| Role | PRESIDENT |
| Phone | 9046200404 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KUDLATS SUSAN P | Agent | 221 SPANISH CREEK DRIVE, PONTE VEDRA, FL, 32081 |
| Name | Role | Address |
|---|---|---|
| KUDLATS SUSAN P | President | 221 SPANISH CREEK DRIVE, PONTE VEDRA, FL, 32081 |
| Name | Role | Address |
|---|---|---|
| Kudlats David | Vice President | 221 SPANISH CREEK DRIVE, PONTE VEDRA, FL, 32081 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000057112 | CRE8 SMILE STUDIO | ACTIVE | 2024-04-30 | 2029-12-31 | No data | 221 SPANISH CREEK DRIVE, PONTE VEDRA, FL, 32081 |
| G18000133456 | KERNAN FAMILY DENTAL CARE | EXPIRED | 2018-12-18 | 2023-12-31 | No data | 12620 BEACH BOULEVARD, SUITE 18, JACKSONVILLE, FL, 32246 |
| G18000129165 | KERNAN FAMILY DENTAL | ACTIVE | 2018-12-06 | 2028-12-31 | No data | 12620 BEACH BLVD SUITE 18, JACKSONVILLE, FL, 32246 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-05 |
| ANNUAL REPORT | 2023-02-20 |
| ANNUAL REPORT | 2022-02-19 |
| ANNUAL REPORT | 2021-02-12 |
| ANNUAL REPORT | 2020-02-15 |
| AMENDED ANNUAL REPORT | 2019-03-20 |
| ANNUAL REPORT | 2019-03-04 |
| Domestic Profit | 2018-09-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
