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  5. MONTEVIDEO FAMILY DENTISTRY, P.A.

MONTEVIDEO FAMILY DENTISTRY, P.A.

Company Details

Name: MONTEVIDEO FAMILY DENTISTRY, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 30 Dec 1996 (28 years ago)
Company Number: 45be1a85-9dd4-e011-a886-001ec94ffe7f
File Number: 9L-793
Registered Office Address: 629 Legion Drive Suite #2, Montevideo, MN 56265, USA
ZIP code: 56265
County: Chippewa County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MONTEVIDEO FAMILY DENTISTRY, P.A. 401K PLAN 2023 411860786 2024-05-31 MONTEVIDEO FAMILY DENTISTRY, P.A. 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 3202696416
Plan sponsor’s address 629 LEGION DRIVE SUITE #2, MONTEVIDEO, MN, 56265

Signature of
Role Plan administrator
Date 2024-05-31
Name of individual signing MATTHEW D VAUGHN
Valid signature Filed with authorized/valid electronic signature
MONTEVIDEO FAMILY DENTISTRY, P.A. 401K PLAN 2022 411860786 2023-07-06 MONTEVIDEO FAMILY DENTISTRY, P.A. 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 3202696416
Plan sponsor’s address 629 LEGION DRIVE SUITE #2, MONTEVIDEO, MN, 56265

Signature of
Role Plan administrator
Date 2023-07-06
Name of individual signing MATTHEW D VAUGHN
Valid signature Filed with authorized/valid electronic signature
MONTEVIDEO FAMILY DENTISTRY, P.A. 401K PLAN 2021 411860786 2022-07-22 MONTEVIDEO FAMILY DENTISTRY, P.A. 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 3202696416
Plan sponsor’s address 629 LEGION DRIVE SUITE #2, MONTEVIDEO, MN, 56265

Signature of
Role Plan administrator
Date 2022-07-22
Name of individual signing MATTHEW D VAUGHN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-22
Name of individual signing MATTHEW D VAUGHN
Valid signature Filed with authorized/valid electronic signature
MONTEVIDEO FAMILY DENTISTRY, P.A. 401K PLAN 2020 411860786 2021-07-05 MONTEVIDEO FAMILY DENTISTRY, P.A. 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 3202696416
Plan sponsor’s address 629 LEGION DRIVE SUITE #2, MONTEVIDEO, MN, 56265

Signature of
Role Plan administrator
Date 2021-07-05
Name of individual signing MATTHEW VAUGHN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-07-05
Name of individual signing MATTHEW D VAUGHN
Valid signature Filed with authorized/valid electronic signature
MONTEVIDEO FAMILY DENTISTRY, P.A. 401K PLAN 2019 411860786 2020-07-23 MONTEVIDEO FAMILY DENTISTRY, P.A. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 3202696416
Plan sponsor’s address 629 LEGION DRIVE SUITE #2, MONTEVIDEO, MN, 56265

Signature of
Role Plan administrator
Date 2020-07-23
Name of individual signing MATTHEW VAUGHN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-23
Name of individual signing MATTHEW D VAUGHN
Valid signature Filed with authorized/valid electronic signature
MONTEVIDEO FAMILY DENTISTRY, P.A. 401K PLAN 2018 411860786 2019-06-27 MONTEVIDEO FAMILY DENTISTRY, P.A. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 3202696416
Plan sponsor’s address 1317 GROVE AVE, MONTEVIDEO, MN, 56265

Signature of
Role Plan administrator
Date 2019-06-27
Name of individual signing MATTHEW VAUGHN
Valid signature Filed with authorized/valid electronic signature
MONTEVIDEO FAMILY DENTISTRY, P.A. 401K PLAN 2017 411860786 2018-05-17 MONTEVIDEO FAMILY DENTISTRY, P.A. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 3202696416
Plan sponsor’s address 1317 GROVE AVE, MONTEVIDEO, MN, 56265

Signature of
Role Plan administrator
Date 2018-05-17
Name of individual signing MATTHEW VAUGHN
Valid signature Filed with authorized/valid electronic signature
MONTEVIDEO FAMILY DENTISTRY, P.A. 401K PLAN 2016 411860786 2017-07-26 MONTEVIDEO FAMILY DENTISTRY, P.A. 24
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 3202696416
Plan sponsor’s address 1317 GROVE AVE, MONTEVIDEO, MN, 56265

Signature of
Role Plan administrator
Date 2017-07-25
Name of individual signing JAMES K. ZENK
Valid signature Filed with authorized/valid electronic signature
MONTEVIDEO FAMILY DENTISTRY, P.A. 401K PLAN 2015 411860786 2016-07-25 MONTEVIDEO FAMILY DENTISTRY, P.A. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 3202696416
Plan sponsor’s address 1317 GROVE AVE, MONTEVIDEO, MN, 56265

Signature of
Role Plan administrator
Date 2016-07-25
Name of individual signing JAMES K. ZENK
Valid signature Filed with authorized/valid electronic signature
MONTEVIDEO FAMILY DENTISTRY, P.A. 401K PLAN 2014 411860786 2015-07-22 MONTEVIDEO FAMILY DENTISTRY, P.A. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 3202696416
Plan sponsor’s address 1317 GROVE AVE, MONTEVIDEO, MN, 56265

Signature of
Role Plan administrator
Date 2015-07-22
Name of individual signing JAMES K. ZENK
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Ashley Jo A. Patton Chief Executive Officer 629 Legion Drive Suite #2, Montevideo, MN 56265, USA

Agent

Name Role
Matthew D Vaughn Agent

Filing

Filing Name Filing date
Registered Office and/or Agent - Business Corporation (Domestic) 2023-03-10
Amendment - Business Corporation (Domestic) 2017-12-18
Original Filing - Business Corporation (Domestic) (Business Name: MONTEVIDEO FAMILY DENTISTRY, P.A.)Professional Service - Dentistry & Dental Hygiene 1996-12-30

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Date of last update: 02 Oct 2024

Sources: Minnesota's Official State Website

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