| Entity Name: | COUNTYLINE DENTISTRY, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 10 Dec 2019 (5 years ago) |
| Document Number: | P19000093324 |
| FEI/EIN Number | 84-4055891 |
| Address: | 21457 NW 2ND AVENUE, MIAMI GARDENS, FL 33169 |
| Mail Address: | 16600 SW 52ND PLACE, SW RANCHES, FL 33331 |
| ZIP code: | 33169 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548892995 | 2020-02-04 | 2020-02-04 | 16600 SW 52ND PL, SOUTHWEST RANCHES, FL, 333311340, US | 21475 NW 2ND AVE, MIAMI, FL, 331693316, US | |||||||||||||||
|
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| Phone | +1 954-298-5582 |
| Phone | +1 305-654-1234 |
Authorized person
| Name | CHRIS KEANE |
| Role | PRESIDENT/ OWNER |
| Phone | 9542985582 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KEANE, CHRISTOPHER T | Agent | 16600 SW 52ND PLACE, SW RANCHES, FL 33331 |
| Name | Role | Address |
|---|---|---|
| KEANE, CHRISTOPHER | President | 16600 SW 52ND PLACE, SW RANCHES, FL 33331 UN |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-02 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-05-01 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-02-05 |
| Domestic Profit | 2019-12-10 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
