| Entity Name: | THE SMILE STORE - PALM BEACH GARDENS, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
THE SMILE STORE - PALM BEACH GARDENS, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 24 Jan 2022 (3 years ago) |
| Date of dissolution: | 19 Jul 2023 (2 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 19 Jul 2023 (2 years ago) |
| Document Number: | P22000007765 |
| Address: | 4362 NORTHLAKE BLVD, SUITE 114, PALM BEACH GARDENS, FL, 33410 |
| Mail Address: | 4362 NORTHLAKE BLVD, SUITE 114, PALM BEACH GARDENS, FL, 33410 |
| ZIP code: | 33410 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396492898 | 2022-03-04 | 2022-03-04 | 4362 NORTHLAKE BLVD STE 114, PALM BEACH GARDENS, FL, 334106269, US | 4362 NORTHLAKE BLVD STE 114, PALM BEACH GARDENS, FL, 334106269, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 561-658-4100 |
| Fax | 8663332309 |
Authorized person
| Name | DR. NICHOLAS J. SAVASTANO JR. |
| Role | OWNER/DOCTOR |
| Phone | 5616584100 |
Taxonomy
| Taxonomy Code | 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 105737100 |
| State | FL |
| Issuer | TYPE 1 NPI PROVIDER ID DR. SAVASTANO |
| Number | 1154348233 |
| State | FL |
| Issuer | NPI 2 OF OLD TIN/LLC NAME FOR SAME DOCTOR, SAME LOCATION |
| Number | 1518505692 |
| State | FL |
| Issuer | DENTAL LICENSE |
| Number | DN15487 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SAVASTANO NICHOLAS JR. | President | 4362 NORTHLAKE BLVD. STE 114, PALM BEACH GARDENS, FL, 33410 |
| SAVASTANO NICHOLAS JR. | Vice President | 4362 NORTHLAKE BLVD. STE 114, PALM BEACH GARDENS, FL, 33410 |
| CAPITOL CORPORATE SERVICES, INC. | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000019445 | THE SMILE STORE | ACTIVE | 2022-02-16 | 2027-12-31 | - | 4362 NORTHLAKE BLVD, SUITE 1000, WEST PALM BEACH, FL, 33401 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-07-19 | - | - |
| REGISTERED AGENT NAME CHANGED | 2022-05-03 | CAPITOL CORPORATE SERVICES, INC. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2022-05-03 | 515 EAST PARK AVENUE, 2ND FL, TALLAHASSEE, FL 32301 | - |
| AMENDMENT AND NAME CHANGE | 2022-02-22 | THE SMILE STORE - PALM BEACH GARDENS, P.A. | - |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2023-07-19 |
| Reg. Agent Change | 2022-05-03 |
| Amendment and Name Change | 2022-02-22 |
| Domestic Profit | 2022-01-24 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
