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  5. Granite City Family & Cosmetic Dentistry

Granite City Family & Cosmetic Dentistry

Company Details

Name: Granite City Family & Cosmetic Dentistry
Jurisdiction: Minnesota
Legal type: Assumed Name
Status: Inactive
Date formed: 15 Jun 2006 (19 years ago)
Company Number: 3a6328df-8dd4-e011-a886-001ec94ffe7f
File Number: 1895457-2
Principal Place of Business Address: 4140 Thielman Ln #208, St Cloud, MN 56301, USA
ZIP code: 56301
County: Stearns County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GRANITE CITY FAMILY & COSMETIC DENTISTRY 401K PLAN 2023 204990679 2024-06-18 GRANITE CITY FAMILY & COSMETIC DENTISTRY 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3202524126
Plan sponsor’s address 429 GREAK OAK DRIVE, WAITE PARK, MN, 56387

Signature of
Role Plan administrator
Date 2024-06-18
Name of individual signing JASON PETERSON
Valid signature Filed with authorized/valid electronic signature
GRANITE CITY FAMILY & COSMETIC DENTISTRY 401K PLAN 2022 204990679 2023-08-21 GRANITE CITY FAMILY & COSMETIC DENTISTRY 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3202524126
Plan sponsor’s address 429 GREAK OAK DRIVE, WAITE PARK, MN, 56387

Signature of
Role Plan administrator
Date 2023-08-21
Name of individual signing JASON PETERSON
Valid signature Filed with authorized/valid electronic signature
GRANITE CITY FAMILY & COSMETIC DENTISTRY 401K PLAN 2021 204990679 2022-07-19 GRANITE CITY FAMILY & COSMETIC DENTISTRY 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3202524126
Plan sponsor’s address 429 GREAK OAK DRIVE, WAITE PARK, MN, 56387

Signature of
Role Plan administrator
Date 2022-07-19
Name of individual signing JASON PETERSON
Valid signature Filed with authorized/valid electronic signature
GRANITE CITY FAMILY & COSMETIC DENTISTRY 401K PLAN 2020 204990679 2021-08-09 GRANITE CITY FAMILY & COSMETIC DENTISTRY 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3202524126
Plan sponsor’s address 429 GREAK OAK DRIVE, WAITE PARK, MN, 56387

Signature of
Role Plan administrator
Date 2021-08-09
Name of individual signing JASON PETERSON
Valid signature Filed with authorized/valid electronic signature
GRANITE CITY FAMILY & COSMETIC DENTISTRY 401K PLAN 2019 204990679 2020-05-26 GRANITE CITY FAMILY & COSMETIC DENTISTRY 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3202524126
Plan sponsor’s address 429 GREAK OAK DRIVE, WAITE PARK, MN, 56387

Signature of
Role Plan administrator
Date 2020-05-26
Name of individual signing JASON PETERSON
Valid signature Filed with authorized/valid electronic signature
GRANITE CITY FAMILY & COSMETIC DENTISTRY 401K PLAN 2018 204990679 2019-10-03 GRANITE CITY FAMILY & COSMETIC DENTISTRY 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3202524126
Plan sponsor’s address 429 GREAK OAK DRIVE, WAITE PARK, MN, 56387

Signature of
Role Plan administrator
Date 2019-10-03
Name of individual signing JASON PETERSON
Valid signature Filed with authorized/valid electronic signature
GRANITE CITY FAMILY & COSMETIC DENTISTRY 401K PLAN 2017 204990679 2018-10-03 GRANITE CITY FAMILY & COSMETIC DENTISTRY 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3202524126
Plan sponsor’s address 4140 THIELMAN LANE SUITE 208, ST. CLOUD, MN, 56301

Signature of
Role Plan administrator
Date 2018-10-03
Name of individual signing JASON PETERSON
Valid signature Filed with authorized/valid electronic signature
GRANITE CITY FAMILY & COSMETIC DENTISTRY 401K PLAN 2016 204990679 2017-09-20 GRANITE CITY FAMILY & COSMETIC DENTISTRY 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3202524126
Plan sponsor’s address 4140 THIELMAN LANE SUITE 208, ST. CLOUD, MN, 56301

Signature of
Role Plan administrator
Date 2017-09-20
Name of individual signing JASON
Valid signature Filed with authorized/valid electronic signature
GRANITE CITY FAMILY & COSMETIC DENTISTRY 401K PLAN 2015 204990679 2016-10-14 GRANITE CITY FAMILY & COSMETIC DENTISTRY 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3202524126
Plan sponsor’s address 4140 THIELMAN LANE SUITE 208, ST. CLOUD, MN, 56301

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing JASON PETERSON
Valid signature Filed with authorized/valid electronic signature
GRANITE CITY FAMILY & COSMETIC DENTISTRY 401K PLAN 2014 204990679 2015-07-23 GRANITE CITY FAMILY & COSMETIC DENTISTRY 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3202524126
Plan sponsor’s address 4140 THIELMAN LANE SUITE 208, ST. CLOUD, MN, 56301

Signature of
Role Plan administrator
Date 2015-07-23
Name of individual signing JASON PETERSON
Valid signature Filed with authorized/valid electronic signature

Aplicant

Name Role Address
AlbertLee Inc Aplicant 4140 Thelman Ln #208, St Cloud, MN 56301

Filing

Filing Name Filing date
Expired - Assumed Name 2016-06-16
Original Filing - Assumed Name (Business Name: Granite City Family & Cosmetic Dentistry) 2006-06-15

Related by officers

No related officers

Related by address

4140 Thielman Ln #208, St Cloud, MN 56301, USA

Advance Credit, Inc. AlbertLee, Inc.

Date of last update: 26 Sep 2024

Sources: Minnesota's Official State Website

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