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SOUTH FORK FAMILY DENTISTRY P.C.

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Company Details

Name: SOUTH FORK FAMILY DENTISTRY P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 25 May 2023 (2 years ago)
Entity Number: 6843174
ZIP code: 11942
County: Suffolk
Place of Formation: New York
Address: 426 montauk highway, EAST QUOGUE, NY, United States, 11942

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
the corporation DOS Process Agent 426 montauk highway, EAST QUOGUE, NY, United States, 11942

National Provider Identifier

NPI Number:
1720766868
Certification Date:
2023-07-09

Authorized Person:

Name:
DR. VICTORIA ELENA SHACK
Role:
PRESIDENT
Phone:

Taxonomy:

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

Contacts:

History

Start date End date Type Value
2023-05-25 2023-07-11 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
230525001385 2023-05-25 CERTIFICATE OF INCORPORATION 2023-05-25

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Date of last update: 20 Mar 2025

Sources: New York Secretary of State