| Entity Name: | BLANDING DENTAL ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 11 Jul 2019 (6 years ago) |
| Document Number: | P19000057107 |
| FEI/EIN Number | 84-2629008 |
| Address: | 767 BLANDING BLVD., SUITE 108, ORANGE PARK, FL, 32065, US |
| Mail Address: | 767 BLANDING BLVD., SUITE 108, ORANGE PARK, FL, 32065, US |
| ZIP code: | 32065 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013562941 | 2019-08-07 | 2019-08-07 | 767 BLANDING BLVD STE 108, ORANGE PARK, FL, 320655788, US | 767 BLANDING BLVD STE 108, ORANGE PARK, FL, 320655788, US | |||||||||||||
|
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| Phone | +1 904-272-6244 |
Authorized person
| Name | DR. JOHN CHAMBERLAIN |
| Role | PRESIDENT |
| Phone | 5964478838 |
Taxonomy
| Taxonomy Code | 1223P0700X - Prosthodontist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JOHN CHAMBERLAIN | Agent | 767 BLANDING BLVD, ORANGE PARK, FL, 32065 |
| Name | Role | Address |
|---|---|---|
| CHAMBERLAIN JOHN A | President | 767 BLANDING BLVD., SUITE 108, ORANGE PARK, FL, 32065 |
| Name | Role | Address |
|---|---|---|
| CHAMBERLAIN JOHN A | Secretary | 767 BLANDING BLVD., SUITE 108, ORANGE PARK, FL, 32065 |
| Name | Role | Address |
|---|---|---|
| CHAMBERLAIN JOHN A | Treasurer | 767 BLANDING BLVD., SUITE 108, ORANGE PARK, FL, 32065 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-29 | JOHN, CHAMBERLAIN | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-29 | 767 BLANDING BLVD, SUITE 108, ORANGE PARK, FL 32065 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-29 |
| ANNUAL REPORT | 2023-03-13 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-01-26 |
| ANNUAL REPORT | 2020-01-20 |
| Domestic Profit | 2019-07-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
