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  5. Anderson Family Dental

Anderson Family Dental

Company Details

Name: Anderson Family Dental
Jurisdiction: Minnesota
Legal type: Assumed Name
Status: Active / In Good Standing
Date formed: 09 Aug 2012 (12 years ago)
Company Number: b6447a31-51e2-e111-afc0-001ec94ffe7f
File Number: 612920200023
Principal Place of Business Address: 209 McLean Avenue, Coleraine, MN 55722, USA
ZIP code: 55722
County: Itasca County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ANDERSON FAMILY DENTAL 401(K) PLAN 2023 460580305 2024-01-29 ANDERSON FAMILY DENTAL 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 2182451278
Plan sponsor’s address 209 MCLEAN AVENUE, P.O. BOX 756, COLERAINE, MN, 55722

Signature of
Role Plan administrator
Date 2024-01-28
Name of individual signing NATALIE ANDERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-01-28
Name of individual signing NATALIE ANDERSON
Valid signature Filed with authorized/valid electronic signature
ANDERSON FAMILY DENTAL 401(K) PLAN 2022 460580305 2023-03-14 ANDERSON FAMILY DENTAL 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 2182451278
Plan sponsor’s address 209 MCLEAN AVENUE, P.O. BOX 756, COLERAINE, MN, 55722

Signature of
Role Plan administrator
Date 2023-03-14
Name of individual signing NATALIE AND
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-03-14
Name of individual signing NATALIE AND
Valid signature Filed with authorized/valid electronic signature
ANDERSON FAMILY DENTAL 401(K) PLAN 2021 460580305 2022-07-07 ANDERSON FAMILY DENTAL 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 2182451278
Plan sponsor’s address 209 MCLEAN AVENUE, P.O. BOX 756, COLERAINE, MN, 55722

Signature of
Role Plan administrator
Date 2022-06-15
Name of individual signing NATALIE ANDERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-15
Name of individual signing NATALIE ANDERSON
Valid signature Filed with authorized/valid electronic signature
ANDERSON FAMILY DENTAL 401(K) PLAN 2020 460580305 2021-04-19 ANDERSON FAMILY DENTAL 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 2182451278
Plan sponsor’s address 209 MCLEAN AVENUE, P.O. BOX 756, COLERAINE, MN, 55722

Signature of
Role Plan administrator
Date 2021-04-18
Name of individual signing NATALIE ANDERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-18
Name of individual signing NATALIE ANDERSON
Valid signature Filed with authorized/valid electronic signature
ANDERSON FAMILY DENTAL 401(K) PLAN 2019 460580305 2020-10-13 ANDERSON FAMILY DENTAL 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 2182451278
Plan sponsor’s address 209 MCLEAN AVENUE, P.O. BOX 756, COLERAINE, MN, 55722

Signature of
Role Plan administrator
Date 2020-10-13
Name of individual signing NATALIE ANDERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-13
Name of individual signing NATALIE ANDERSON
Valid signature Filed with authorized/valid electronic signature
ANDERSON FAMILY DENTAL 401(K) PLAN 2018 460580305 2019-06-19 ANDERSON FAMILY DENTAL 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 2182451278
Plan sponsor’s address 209 MCLEAN AVENUE, PO BOX 756, COLERAINE, MN, 55722

Signature of
Role Plan administrator
Date 2019-06-19
Name of individual signing NATALIE ANDERSON
Valid signature Filed with authorized/valid electronic signature
ANDERSON FAMILY DENTAL 401(K) PLAN 2017 460580305 2018-06-19 ANDERSON FAMILY DENTAL 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 2182451278
Plan sponsor’s address 209 MCLEAN AVENUE, COLERAINE, MN, 55722

Signature of
Role Plan administrator
Date 2018-06-19
Name of individual signing NATALIE ANDERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-19
Name of individual signing NATALIE ANDERSON
Valid signature Filed with authorized/valid electronic signature
ANDERSON FAMILY DENTAL 401(K) PLAN 2016 460580305 2017-09-19 ANDERSON FAMILY DENTAL 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 2182451278
Plan sponsor’s address 209 MCLEAN AVENUE, COLERAINE, MN, 55722

Signature of
Role Plan administrator
Date 2017-09-19
Name of individual signing NATALIE ANDERSON
Valid signature Filed with authorized/valid electronic signature

Aplicant

Name Role Address
Anderson Family Dental, P.A. Aplicant 209 McLean Avenue, Coleraine, MN 55722

Filing

Filing Name Filing date
Annual Reinstatement - Assumed Name 2016-08-18
Administrative Expiration - Assumed Name 2016-03-08
Original Filing - Assumed Name (Business Name: Anderson Family Dental ) 2012-08-09

Related by officers

No related officers

Related by address

209 McLean Avenue, Coleraine, MN 55722, USA

Anderson Family Dental P. A.

Date of last update: 27 Sep 2024

Sources: Minnesota's Official State Website

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