|
EVERSMILES PEDIATRIC DENTISTRY 401(K) PLAN
|
2023
|
412000505
|
2024-10-22
|
EVERSMILES PEDIATRIC DENTISTRY, PLLC
|
20
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2023-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2187282117
|
| Plan sponsor’s
address |
4419 AIR BASE ROAD, HERMANTOWN, MN, 55811
|
|
|
EVERSMILES PEDIATRIC DENTISTRY 401(K) PLAN
|
2023
|
412000505
|
2024-06-25
|
EVERSMILES PEDIATRIC DENTISTRY, PLLC
|
20
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2023-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2187282117
|
| Plan sponsor’s
address |
4419 AIR BASE ROAD, HERMANTOWN, MN, 55811
|
|
|
EVERSMILES PEDIATRIC DENTISTRY 401(K) PROFIT SHARING PLAN
|
2012
|
412000505
|
2013-08-27
|
EVERSMILES PEDIATRIC DENTISTRY, PLLC
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2002-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6125325630
|
| Plan sponsor’s mailing address |
4419 AIR BASE ROAD, HERMANTOWN, MN, 55811
|
| Plan sponsor’s
address |
4419 AIR BASE ROAD, HERMANTOWN, MN, 55811
|
Plan administrator’s name and address
| Administrator’s EIN |
412000505 |
| Plan administrator’s name |
EVERSMILES PEDIATRIC DENTISTRY, PLLC |
| Plan administrator’s
address |
4419 AIR BASE ROAD, HERMANTOWN, MN, 55811 |
| Administrator’s telephone number |
6125325630 |
Number of participants as of the end of the plan year
| Active participants |
0 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
0 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2013-08-27 |
| Name of individual signing |
JOHN CONRY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-08-27 |
| Name of individual signing |
JOHN CONRY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
EVERSMILES PEDIATRIC DENTISTRY 401(K) PROFIT SHARING PLAN
|
2012
|
412000505
|
2013-07-28
|
EVERSMILES PEDIATRIC DENTISTRY, PLLC
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2002-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6125325630
|
| Plan sponsor’s mailing address |
4419 AIR BASE ROAD, HERMANTOWN, MN, 55811
|
| Plan sponsor’s
address |
4419 AIR BASE ROAD, HERMANTOWN, MN, 55811
|
Plan administrator’s name and address
| Administrator’s EIN |
412000505 |
| Plan administrator’s name |
EVERSMILES PEDIATRIC DENTISTRY, PLLC |
| Plan administrator’s
address |
4419 AIR BASE ROAD, HERMANTOWN, MN, 55811 |
| Administrator’s telephone number |
6125325630 |
Number of participants as of the end of the plan year
| Active participants |
9 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
1 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
9 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2013-07-28 |
| Name of individual signing |
JOHN CONRY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-07-28 |
| Name of individual signing |
JOHN CONRY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
EVERSMILES PEDIATRIC DENTISTRY 401(K) PROFIT SHARING PLAN
|
2011
|
412000505
|
2012-05-30
|
EVERSMILES PEDIATRIC DENTISTRY, PLLC
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2002-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6125325630
|
| Plan sponsor’s mailing address |
4419 AIR BASE ROAD, HERMANTOWN, MN, 55811
|
| Plan sponsor’s
address |
4419 AIR BASE ROAD, HERMANTOWN, MN, 55811
|
Plan administrator’s name and address
| Administrator’s EIN |
412000505 |
| Plan administrator’s name |
EVERSMILES PEDIATRIC DENTISTRY, PLLC |
| Plan administrator’s
address |
4419 AIR BASE ROAD, HERMANTOWN, MN, 55811 |
| Administrator’s telephone number |
6125325630 |
Number of participants as of the end of the plan year
| Active participants |
10 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
9 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2012-05-24 |
| Name of individual signing |
JOHN CONRY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
