| Entity Name: | MARK FORREST, D.M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Apr 1998 (27 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 12 Oct 2009 (15 years ago) |
| Document Number: | P98000033118 |
| FEI/EIN Number | 650827738 |
| Address: | 601 N. FLAMINGO ROAD, SUITE 318, PEMBROKE PINES, FL, 33028-1011, US |
| Mail Address: | 601 N. FLAMINGO ROAD, SUITE 318, PEMBROKE PINES, FL, 33028-1011, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992187330 | 2015-06-22 | 2015-06-22 | 601 N. FLAMINGO ROAD, SUITE 318, PEMBROKE PINES, FL, 330281011, US | 601 N. FLAMINGO ROAD, SUITE #318, PEMBROKE PINES, FL, 330281011, US | |||||||||||||||||||
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| Phone | +1 954-435-0100 |
| Fax | 9544308900 |
Authorized person
| Name | MR. MARK B. FORREST |
| Role | DR. |
| Phone | 9544350100 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN5906 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FORREST MARK | Agent | 601 N. FLAMINGO ROAD, PEMBROKE PINES, FL, 330281011 |
| Name | Role | Address |
|---|---|---|
| FORREST MARK | President | 601 N. FLAMINGO ROAD, SUITE 318, PEMBROKE PINES, FL, 330281011 |
| Name | Role | Address |
|---|---|---|
| FORREST MARK | Director | 601 N. FLAMINGO ROAD, SUITE 318, PEMBROKE PINES, FL, 330281011 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CANCEL ADM DISS/REV | 2009-10-12 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-18 |
| ANNUAL REPORT | 2023-03-04 |
| ANNUAL REPORT | 2022-02-05 |
| ANNUAL REPORT | 2021-02-13 |
| ANNUAL REPORT | 2020-01-25 |
| ANNUAL REPORT | 2019-02-16 |
| ANNUAL REPORT | 2018-01-20 |
| ANNUAL REPORT | 2017-01-14 |
| ANNUAL REPORT | 2016-02-26 |
| ANNUAL REPORT | 2015-03-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
