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Iuka Family Dental, PLLC

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Company Details

Name: Iuka Family Dental, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 09 Mar 2021 (4 years ago)
Business ID: 1264808
ZIP code: 38834
County: Alcorn
State of Incorporation: MISSISSIPPI
Principal Office Address: 1025 Foote St.Corinth, MS 38834

Agent

Name Role Address
Edward T. Stark Agent 1025 Foote St, Corinth, MS 38834

Member

Name Role Address
Mark R. Mazurkiewicz, DMD, PA Member 1025 Foote St, Corinth, MS 38834
Edward S. Knight, Jr., DDS, PA Member 1025 Foote St, Corinth, MS 38834
Tiffany T. Hollingsworth, DMD, PA Member 1025 Foote St, Corinth, MS 38834

National Provider Identifier

NPI Number:
1851979868
Certification Date:
2021-03-31

Authorized Person:

Name:
GINGER M. TODD
Role:
INSURANCE COORDINATOR
Phone:

Taxonomy:

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

Contacts:

Fax:
6622873157
Fax:
6626607145

Form 5500 Series

Employer Identification Number (EIN):
862949581
Plan Year:
2023
Number Of Participants:
5
Sponsors Telephone Number:

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2025-05-09 Annual Report For Iuka Family Dental, PLLC
Annual Report LLC Filed 2024-04-15 Annual Report For Iuka Family Dental, PLLC
Amendment Form Filed 2023-09-14 Amendment For Iuka Family Dental, PLLC
Annual Report LLC Filed 2023-04-14 Annual Report For Iuka Family Dental, PLLC
Annual Report LLC Filed 2022-02-28 Annual Report For Iuka Family Dental, PLLC
Amendment Form Filed 2021-07-07 Amendment For Iuka Family Dental, PLLC
Correction Amendment Form Filed 2021-07-06 Correction For Iuka Family Dental, PLLC
Amendment Form Filed 2021-06-18 Amendment For Iuka Family Dental, PLLC
Formation Form Filed 2021-03-09 Formation For Iuka Family Dental, PLLC

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Date of last update: 10 Jul 2025

Sources: Company Profile on Mississippi Secretary of State Website