| Entity Name: | PALM HARBOR FAMILY DENTISTRY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 Aug 2020 (5 years ago) |
| Document Number: | P20000060374 |
| FEI/EIN Number | 852552235 |
| Address: | 3820 TAMPA ROAD, SUITE NO. 201, PALM HARBOR, FL, 34684, US |
| Mail Address: | 3820 TAMPA ROAD, SUITE NO. 201, PALM HARBOR, FL, 34684, US |
| ZIP code: | 34684 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PALM HARBOR DENTAL 401(K) PROFIT SHARING PLAN | 2023 | 852552235 | 2024-05-20 | PALM HARBOR FAMILY DENTISTRY, P.A. | 10 | |||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2024-05-20 |
| Name of individual signing | JOSEPH TAYLOR MASSEY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 621210 |
| Plan sponsor’s address | 3820 TAMPA ROAD, SUITE 201, PALM HARBOR, FL, 34684 |
Signature of
| Role | Plan administrator |
| Date | 2023-06-30 |
| Name of individual signing | JOSEPH TAYLOR MASSEY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 9043995888 |
| Plan sponsor’s address | 3820 TAMPA ROAD, SUITE 201, PALM HARBOR, FL, 34684 |
Signature of
| Role | Plan administrator |
| Date | 2022-08-23 |
| Name of individual signing | JOSEPH TAYLOR MASSEY |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| BLALOCK WALTERS, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| MASSEY JOSEPH T | President | 3820 TAMPA ROAD, PALM HARBOR, FL, 34684 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000017861 | MASSEY FAMILY COSMETIC AND IMPLANT DENTISTRY | ACTIVE | 2024-02-01 | 2029-12-31 | No data | 3820 TAMPA RD., SUITE 201, PALM HARBOR, FL, 34684 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-04-27 | 3820 TAMPA ROAD, SUITE NO. 201, PALM HARBOR, FL 34684 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-04-27 | BLALOCK WALTERS, P.A. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-27 | 802 11th Street West, Bradenton, FL 34205 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-08 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-03-29 |
| AMENDED ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2021-04-26 |
| Domestic Profit | 2020-08-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
