| Entity Name: | TAVARES DENTAL EXCELLENCE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 21 Oct 1999 (25 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P99000093594 |
| FEI/EIN Number | 593610306 |
| Address: | 215 E BURLEIGH BLVD, TAVARES, FL, 32778 |
| Mail Address: | 215 E BURLEIGH BLVD, TAVARES, FL, 32778 |
| ZIP code: | 32778 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TAVARES DENTAL EXCELLENCE, P.A. 401(K) PROFIT SHARING PLAN | 2011 | 593610306 | 2012-10-11 | TAVARES DENTAL EXCELLENCE, P.A. | 1 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 593610306 |
| Plan administrator’s name | TAVARES DENTAL EXCELLENCE, P.A. |
| Plan administrator’s address | 215 E BURLEIGH BLVD, TAVARES, FL, 327782403 |
| Administrator’s telephone number | 3522536400 |
Signature of
| Role | Plan administrator |
| Date | 2012-10-11 |
| Name of individual signing | CHARLES W. REINERTSEN, D.M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 3522536400 |
| Plan sponsor’s address | 215 E BURLEIGH BLVD, TAVARES, FL, 327782403 |
Plan administrator’s name and address
| Administrator’s EIN | 593610306 |
| Plan administrator’s name | TAVARES DENTAL EXCELLENCE, P.A. |
| Plan administrator’s address | 215 E BURLEIGH BLVD, TAVARES, FL, 327782403 |
| Administrator’s telephone number | 3522536400 |
Signature of
| Role | Plan administrator |
| Date | 2011-10-12 |
| Name of individual signing | CHARLES W. REINERTSEN, D.M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 3522536400 |
| Plan sponsor’s address | 215 E BURLEIGH BLVD, TAVARES, FL, 327782403 |
Plan administrator’s name and address
| Administrator’s EIN | 593610306 |
| Plan administrator’s name | TAVARES DENTAL EXCELLENCE, P.A. |
| Plan administrator’s address | 215 E BURLEIGH BLVD, TAVARES, FL, 327782403 |
| Administrator’s telephone number | 3522536400 |
Signature of
| Role | Plan administrator |
| Date | 2010-06-11 |
| Name of individual signing | CHARLES W. REINERTSEN, D.M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| REINERTSEN CHARLES W | Agent | 215 E BURLEIGH BLVD, TAVARES, FL, 32778 |
| Name | Role | Address |
|---|---|---|
| REINERTSEN CHARLES W | Director | 215 E BURLEIGH BLVD, TAVARES, FL, 32778 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-04-03 | 215 E BURLEIGH BLVD, TAVARES, FL 32778 | No data |
| NAME CHANGE AMENDMENT | 2005-02-14 | TAVARES DENTAL EXCELLENCE, P.A. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-02-02 | 215 E BURLEIGH BLVD, TAVARES, FL 32778 | No data |
| CHANGE OF MAILING ADDRESS | 2004-02-02 | 215 E BURLEIGH BLVD, TAVARES, FL 32778 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-01-24 |
| ANNUAL REPORT | 2015-01-21 |
| ANNUAL REPORT | 2014-02-10 |
| ANNUAL REPORT | 2013-03-23 |
| ANNUAL REPORT | 2012-02-10 |
| ANNUAL REPORT | 2011-01-14 |
| ANNUAL REPORT | 2010-02-12 |
| ANNUAL REPORT | 2009-08-11 |
| ANNUAL REPORT | 2008-03-17 |
| ANNUAL REPORT | 2007-03-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
