| Entity Name: | CL DDS 2 PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 05 Jun 2020 (5 years ago) |
| Document Number: | P20000042461 |
| FEI/EIN Number | 85-1428527 |
| Address: | 5431 N. University Drive #102, CORAL SPRINGS, FL, 33067, US |
| Mail Address: | 3320 SW 58TH ST., FT. LAUDERDALE, FL, 33312, US |
| ZIP code: | 33067 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134859010 | 2022-06-14 | 2022-06-14 | 9156 WILES RD, CORAL SPRINGS, FL, 330671999, US | 9156 WILES RD, CORAL SPRINGS, FL, 330671999, US | |||||||||||||||
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| Phone | +1 954-255-2787 |
| Fax | 9542558307 |
Authorized person
| Name | TIFFANI BERNSTEIN |
| Role | PRACTICE MANAGER |
| Phone | 9542552787 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LUSTMAN CRAIG | Agent | 3320 SW 58TH ST., FT. LAUDERDALE, FL, 33312 |
| Name | Role | Address |
|---|---|---|
| LUSTMAN CRAIG | President | 3320 SW 58TH ST., FT. LAUDERDALE, FL, 33312 |
| Name | Role | Address |
|---|---|---|
| Lustman Rebecca | Secretary | 3320 Southwest 58th Street, Fort Lauderdale, FL, 33312 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000065202 | SPLASH! PEDIATRIC DENTISTRY | ACTIVE | 2021-05-12 | 2026-12-31 | No data | 3320 SOUTHWEST 58TH STREET, FORT LAUDERDALE, FL, 33312 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-12-18 | 5431 N. University Drive #102, CORAL SPRINGS, FL 33067 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-12 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-04-05 |
| Domestic Profit | 2020-06-05 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
