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  5. DEERFIELD FAMILY DENTAL, INC.

DEERFIELD FAMILY DENTAL, INC.

Company Details

Entity Name: DEERFIELD FAMILY DENTAL, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 19 Sep 1997 (27 years ago)
Last Event: CANCEL ADM DISS/REV
Event Date Filed: 25 Oct 2004 (20 years ago)
Document Number: P97000081273
FEI/EIN Number 650782230
Address: 100 SOUTH MILITARY TRAIL, 4, DEERFIELD BEACH, FL, 33442
Mail Address: 100 SOUTH MILITARY TRAIL, 4, DEERFIELD BEACH, FL, 33442
ZIP code: 33442
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1679907752 2013-08-26 2013-08-26 100 S MILITARY TRL, STE 4, DEERFIELD BEACH, FL, 334423015, US 100 S MILITARY TRL, STE 4, DEERFIELD BEACH, FL, 334423015, US

Contacts
Phone +1 954-725-3717

Authorized person
Name ALAIN POULERIGUEN
Role PRESIDENT
Phone 9547253717

Taxonomy
Taxonomy Code 122300000X - Dentist
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DEERFIELD FAMILY DENTAL 401(K) PLAN 2023 650782230 2024-06-11 DEERFIELD FAMILY DENTAL, INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 5615427186
Plan sponsor’s address 100 SOUTH MILITARY TRAIL, STE. 4, DEERFIELD, FL, 85048

Signature of
Role Plan administrator
Date 2024-06-05
Name of individual signing ALAIN POULERIGUEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-06-11
Name of individual signing ANTONIO FESTA
Valid signature Filed with authorized/valid electronic signature
DEERFIELD FAMILY DENTAL 401(K) PLAN 2022 650782230 2023-07-10 DEERFIELD FAMILY DENTAL, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 5615427186
Plan sponsor’s address 100 SOUTH MILITARY TRAIL, STE. 4, DEERFIELD, FL, 85048

Signature of
Role Plan administrator
Date 2023-07-10
Name of individual signing ALAIN POULERIGUEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-10
Name of individual signing ANTONIO FESTA
Valid signature Filed with authorized/valid electronic signature
DEERFIELD FAMILY DENTAL 401(K) PLAN 2021 650782230 2022-07-27 DEERFIELD FAMILY DENTAL, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 5615427186
Plan sponsor’s address 100 SOUTH MILITARY TRAIL, STE. 4, DEERFIELD, FL, 85048

Signature of
Role Plan administrator
Date 2022-07-27
Name of individual signing ALAIN POULERIGUEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-26
Name of individual signing ANTONIO FESTA
Valid signature Filed with authorized/valid electronic signature
DEERFIELD FAMILY DENTAL 401(K) PLAN 2020 650782230 2021-06-22 DEERFIELD FAMILY DENTAL, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 5615427186
Plan sponsor’s address 100 SOUTH MILITARY TRAIL, STE. 4, DEERFIELD, FL, 85048

Signature of
Role Plan administrator
Date 2021-06-22
Name of individual signing ALAIN POULERIGUEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-06-08
Name of individual signing ANTONIO FESTA
Valid signature Filed with authorized/valid electronic signature
DEERFIELD FAMILY DENTAL 401(K) PLAN 2019 650782230 2020-05-26 DEERFIELD FAMILY DENTAL, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 5615427186
Plan sponsor’s address 100 SOUTH MILITARY TRAIL, STE. 4, DEERFIELD, FL, 85048

Signature of
Role Plan administrator
Date 2020-05-25
Name of individual signing ALAIN POULERIGUEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-05-26
Name of individual signing ANTONIO FESTA
Valid signature Filed with authorized/valid electronic signature
DEERFIELD FAMILY DENTAL 401(K) PLAN 2018 650782230 2019-05-30 DEERFIELD FAMILY DENTAL, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 5615427186
Plan sponsor’s address 100 SOUTH MILITARY TRAIL, STE. 4, DEERFIELD, FL, 85048

Signature of
Role Plan administrator
Date 2019-05-16
Name of individual signing ALAIN POULERIGUEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-30
Name of individual signing ANTONIO FESTA
Valid signature Filed with authorized/valid electronic signature
DEERFIELD FAMILY DENTAL 401(K) PLAN 2017 650782230 2018-06-01 DEERFIELD FAMILY DENTAL, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 5615427186
Plan sponsor’s address 100 SOUTH MILITARY TRAIL, STE. 4, DEERFIELD, FL, 85048

Signature of
Role Plan administrator
Date 2018-06-01
Name of individual signing ALAIN POULERIGUEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-01
Name of individual signing ANTONIO FESTA
Valid signature Filed with authorized/valid electronic signature
DEERFIELD FAMILY DENTAL 401(K) PLAN 2016 650782230 2017-08-28 DEERFIELD FAMILY DENTAL, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 5615427186
Plan sponsor’s address 100 SOUTH MILITARY TRAIL, STE. 4, DEERFIELD BEACH, FL, 85048

Signature of
Role Plan administrator
Date 2017-07-29
Name of individual signing ALAIN POULERIGUEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-28
Name of individual signing ANTONIO FESTA
Valid signature Filed with authorized/valid electronic signature
DEERFIELD FAMILY DENTAL 401(K) PLAN 2015 650782230 2016-08-03 DEERFIELD FAMILY DENTAL, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 5615427186
Plan sponsor’s address 100 SOUTH MILITARY TRAIL, STE. 4, DEERFIELD BEACH, FL, 85048
DEERFIELD FAMILY DENTAL 401(K) PLAN 2014 650782230 2015-07-28 DEERFIELD FAMILY DENTAL, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 812990
Sponsor’s telephone number 5615427186
Plan sponsor’s address 100 SOUTH MILITARY TRAIL, STE. 4, DEERFIELD, FL, 33442

Signature of
Role Plan administrator
Date 2015-07-28
Name of individual signing ALAIN POULERIGUEN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
POULERIGUEN ALAIN Agent 100 SOUTH MILITARY TRAIL, DEERFIELD BEACH, FL, 33442

President

Name Role Address
POULERIGUEN ALAIN President 100 SOUTH MILITARY TRAIL, DEERFIELD BEACH, FL, 33442

Vice President

Name Role Address
FESTA ANTONIO Vice President 100 SOUTH MILITARY TRAIL, DEERFIELD BEACH, FL, 33442

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2007-04-12 100 SOUTH MILITARY TRAIL, 4, DEERFIELD BEACH, FL 33442 No data
CHANGE OF MAILING ADDRESS 2006-05-01 100 SOUTH MILITARY TRAIL, 4, DEERFIELD BEACH, FL 33442 No data
REGISTERED AGENT ADDRESS CHANGED 2006-05-01 100 SOUTH MILITARY TRAIL, 4, DEERFIELD BEACH, FL 33442 No data
CANCEL ADM DISS/REV 2004-10-25 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2004-10-01 No data No data
REGISTERED AGENT NAME CHANGED 1998-06-03 POULERIGUEN, ALAIN No data

Documents

Name Date
ANNUAL REPORT 2024-04-10
ANNUAL REPORT 2023-04-10
ANNUAL REPORT 2022-03-09
ANNUAL REPORT 2021-03-24
ANNUAL REPORT 2020-06-08
ANNUAL REPORT 2019-03-09
ANNUAL REPORT 2018-02-13
ANNUAL REPORT 2017-04-12
ANNUAL REPORT 2016-02-24
ANNUAL REPORT 2015-02-26

Related by officers

POULERIGUEN ALAIN

MABLE VENTURES LLC LASER & COSMETIC DENTISTRY OF DELRAY, INC.

FESTA ANTONIO

5FLOODFIRE LLC DENTIST-911 LLC SUNDAY PAPER FLYER LLC MABLE VENTURES LLC LASER & COSMETIC DENTISTRY OF DELRAY, INC. PURO POLLO LLC

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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