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AFFORDABLE DENTURES & IMPLANTS - WEST MELBOURNE II, P.A. - Florida Company Profile

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Company Details

Entity Name: AFFORDABLE DENTURES & IMPLANTS - WEST MELBOURNE II, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 03 Apr 2019 (6 years ago)
Document Number: P19000030387
FEI/EIN Number 83-4272440
Mail Address: 629 DAVIS DRIVE, SUITE 300, MORRISVILLE, NC, 27560, US
Address: 1529 W. NEW HAVEN AVE., WEST MELBOURNE, FL, 32904
ZIP code: 32904
City: Melbourne
County: Brevard
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
- Agent -
COULTER MARK President 1529 W. NEW HAVEN AVE., WEST MELBOURNE, FL, 32904
GAINES BRETT Assistant 629 DAVIS DRIVE, MORRISVILLE, NC, 27560
Lasseter Anna Secretary 629 DAVIS DRIVE, MORRISVILLE, NC, 27560

National Provider Identifier

NPI Number:
1265249676
Certification Date:
2024-12-18

Authorized Person:

Name:
MARK COULTER
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G20000112067 AFFORDABLE DENTURES & IMPLANTS - WEST MELBOURNE ACTIVE 2020-08-28 2025-12-31 - 629 DAVIS DRIVE, SUITE 300, MORRISVILLE, NC, 27560

Documents

Name Date
ANNUAL REPORT 2025-01-03
ANNUAL REPORT 2024-01-08
ANNUAL REPORT 2023-01-26
ANNUAL REPORT 2022-04-01
ANNUAL REPORT 2021-04-27
ANNUAL REPORT 2020-03-30
Domestic Profit 2019-04-03

Paycheck Protection Program

Jobs Reported:
8
Initial Approval Amount:
$109,305
Date Approved:
2020-04-30
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$109,430
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$110,857.09
Servicing Lender:
Bank of America, National Association
Use of Proceeds:
Payroll: $109,430

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Date of last update: 03 Aug 2025

Sources: Florida Department of State