| Entity Name: | JOHN B. DRAPER, DMD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Sep 2022 (2 years ago) |
| Document Number: | P22000071911 |
| FEI/EIN Number | 92-0443065 |
| Address: | 800 ZEAGLER DRIVE, SUITE NO. 330, PALATKA, FL, 32177 |
| Mail Address: | 800 ZEAGLER DRIVE, SUITE NO. 330, PALATKA, FL, 32177 |
| ZIP code: | 32177 |
| County: | Putnam |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336858174 | 2022-11-21 | 2022-11-21 | 800 ZEAGLER DR STE 330, PALATKA, FL, 321773827, US | 800 ZEAGLER DR STE 330, PALATKA, FL, 321773827, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 386-325-6000 |
| Fax | 3863259306 |
Authorized person
| Name | JOHN B DRAPER |
| Role | DOCTOR |
| Phone | 3863256000 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN B DRAPER 401(K) PLAN | 2023 | 920443065 | 2024-03-11 | JOHN B. DRAPER, DMD, PA | 10 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-03-11 |
| Name of individual signing | JOHN DRAPER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DRAPER JOHN BDMD | Agent | 800 ZEAGLER DRIVE, PALATKA, FL, 32177 |
| Name | Role | Address |
|---|---|---|
| DRAPER JOHN BDMD | President | 800 ZEAGLER DRIVE, SUITE NO. 330, PALATKA, FL, 32177 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000065006 | DRAPER DENTAL | ACTIVE | 2024-05-22 | 2029-12-31 | No data | 800 ZEAGLE DR, STE 330, PALATKA, FL, 32177 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-03-22 |
| Domestic Profit | 2022-09-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
