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EDOUARD ETLIS DENTAL P.C.

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Company Details

Name: EDOUARD ETLIS DENTAL P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 29 Sep 2015 (10 years ago)
Entity Number: 4827011
ZIP code: 10305
County: Richmond
Place of Formation: New York
Address: 80 FOCH AVENUE, STATEN ISLAND, NY, United States, 10305

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 80 FOCH AVENUE, STATEN ISLAND, NY, United States, 10305

National Provider Identifier

NPI Number:
1952765828

Authorized Person:

Name:
EDOUARD ETLIS
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fax:
7184958803

Filings

Filing Number Date Filed Type Effective Date
150929000776 2015-09-29 CERTIFICATE OF INCORPORATION 2015-09-29

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Date of last update: 25 Mar 2025

Sources: New York Secretary of State