Polk County Dental Association
Dr. Max Forni,
PRESIDENT
701 FL-60, Lake Wales 33853
863-676-6021
drforni@outlook.com
*Dr. Samuel Pero,
PRESIDENT ELECT AND PROGRAM CHAIR
701 FL-60, Lake Wales 33853
863-676-6021
samperoiv@gmail.com
Dr. Annie Siassipour,
FIRST VICE-PRESIDENT
701 FL-60, Lake Wales 33853
863/676-6021
annie.siassipour@gmail.com
Dr. Jonathan Scott,
SECRETARY
5110 South Lakeland Drive, Lakeland 33813
863/709-1941
jds@scottsmiles.com
Dr. Charles D. Llano,
Treasurer
320 West Highland Drive, Lakeland 33813
863/668-8222
lakelanddds@gmail.com
Ms. Susan Rexroat,
GIVE KIDS A SMILE CONTACT PERSON
3225 Winter Lake Road, Lakeland 33803
863/499-2700
FAX 863/497-2706
susan.rexroat@polk-fl.net
Ms. Tisha Talbot, E
XECUTIVE SECRETARY
1132 Maplebrook Drive, Lake Alfred 33850
863/236-7610
pcdaemail@gmail.com
*Christopher M. Bulnes, DMD,
WCDDA OFFICER LIAISON
3906 West Neptune Street, Tampa 33629
813/259-9000
FAX 813/259-9923
trimile26@gmail.com