| Entity Name: | BESPOKE SMILES DENTISTRY, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 04 Sep 2024 (6 months ago) |
| Document Number: | P24000057089 |
| Address: | 5770 Wiles Rd, Coral Springs, FL 33067 |
| Mail Address: | 5770 Wiles Rd, Coral Springs, FL 33067 |
| ZIP code: | 33067 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942036264 | 2024-09-12 | 2024-11-07 | 5770 WILES RD, CORAL SPRINGS, FL, 330672156, US | 5770 WILES RD, CORAL SPRINGS, FL, 330672156, US | |||||||||||||
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| Phone | +1 954-255-5166 |
Authorized person
| Name | DR. GILI LITWACK |
| Role | PRESIDENT |
| Phone | 5163420308 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LITWACK, GILI | Agent | 455 NE 24TH STREET, APT 417, MIAMI, FL 33137 |
| Name | Role | Address |
|---|---|---|
| LITWACK, GILI | President | 5770 WILES RD, CORAL SPRINGS, FL 33067 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000131133 | CREEKSIDE DENTAL EXCELLENCE | ACTIVE | 2024-10-24 | 2029-12-31 | No data | 5770 WILES RD, CORAL SPRINGS, FL, 33067 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-24 | 5770 Wiles Rd, Coral Springs, FL 33067 | No data |
| CHANGE OF MAILING ADDRESS | 2024-10-24 | 5770 Wiles Rd, Coral Springs, FL 33067 | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2024-09-04 |
Date of last update: 07 Feb 2025
Sources: Florida Department of State
