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GREEN LAKES DENTAL LLP

Company Details

Name: GREEN LAKES DENTAL LLP
Jurisdiction: New York
Legal type: DOMESTIC REGISTERED LIMITED LIABILITY PARTNERSHIP
Status: Active
Date of registration: 22 Jun 2022 (3 years ago)
Entity Number: 6518320
ZIP code: 13066
Place of Formation: New York
Address: 511 east genesee street, FAYETTEVILLE, NY, United States, 13066
Principal Address: 105 maple drive, FAYETTEVILLE, United States, 13066

DOS Process Agent

Name Role Address
the partnership DOS Process Agent 511 east genesee street, FAYETTEVILLE, NY, United States, 13066

National Provider Identifier

NPI Number:
1174259212
Certification Date:
2022-07-30

Authorized Person:

Name:
DR. TYLER MAXWELL
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QD0000X - Dental Clinic/Center
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
882923899
Plan Year:
2023
Number Of Participants:
9
Sponsors Telephone Number:

History

Start date End date Type Value
2022-08-17 2022-09-01 Address 105 maple drive, FAYETTEVILLE, NY, 13066, 1624, USA (Type of address: Service of Process)
2022-06-22 2022-08-17 Address 105 maple drive, FAYETTEVILLE, NY, 13066, 1624, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
220901003909 2022-08-31 CERTIFICATE OF AMENDMENT 2022-08-31
220817003412 2022-08-17 CERTIFICATE OF PUBLICATION 2022-08-17
220622002606 2022-06-22 CERTIFICATE OF REGISTRATION 2022-06-22

Date of last update: 21 Mar 2025

Sources: New York Secretary of State