| Entity Name: | TEMPLE TERRACE DENTAL, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 Apr 1997 (28 years ago) |
| Document Number: | P97000030280 |
| FEI/EIN Number | 650739771 |
| Address: | 11203 N 56TH ST, SUITE D, TEMPLE TERRACE, FL, 33617 |
| Mail Address: | 6240 LAKE OSPREY DR., SARASOTA, FL, 34240 |
| ZIP code: | 33617 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932231321 | 2007-03-12 | 2010-01-22 | 11157 N 56TH ST, TEMPLE TERRACE, FL, 336172901, US | 11157 N 56TH ST, TEMPLE TERRACE, FL, 336172901, US | |||||||||||||
|
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| Phone | +1 813-985-2477 |
Authorized person
| Name | MIKE COLE |
| Role | INSURANCE DIRECTOR |
| Phone | 7277261611 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| CORONA DENNIS | Director | 6240 LAKE OSPREY DR., SARASOTA, FL, 34240 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000012188 | ADVANCED DENTAL CARE | EXPIRED | 2018-01-22 | 2023-12-31 | No data | 6240 LAKE OSPREY DRIVE, SARASOTA, FL, 34240 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
