|
MAIN DENTAL PLLC CBS BENEFIT PLAN
|
2023
|
921389092
|
2024-12-30
|
MAIN DENTAL PLLC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2024-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2707374746
|
| Plan sponsor’s
address |
1205 WOODLAND DRIVE, ELIZABETHTOWN, KY, 42701
|
Plan administrator’s name and address
| Administrator’s EIN |
846429706 |
| Plan administrator’s name |
JOSEPH HSU |
| Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number |
5026954700 |
Signature of
| Role |
Plan administrator |
| Date |
2024-12-30 |
| Name of individual signing |
JOSEPH HSU |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MAIN DENTAL PLLC 401(K) PLAN
|
2023
|
921389092
|
2024-05-20
|
MAIN DENTAL PLLC
|
0
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2023-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
2707374746
|
| Plan sponsor’s
address |
1205 WOODLAND DR, ELIZABETHTOWN, KY, 42701
|
Plan administrator’s name and address
| Administrator’s EIN |
474474775 |
| Plan administrator’s name |
GUIDELINE, INC. |
| Plan administrator’s
address |
1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number |
8882283491 |
Signature of
| Role |
Plan administrator |
| Date |
2024-05-20 |
| Name of individual signing |
QIAN LIU |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
