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FACIAL & ORAL SURGERY ASSOCIATES, P.A.

Company Details

Name: FACIAL & ORAL SURGERY ASSOCIATES, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 01 Oct 1974 (50 years ago)
Financial Date End: 31 Oct 2025
Entity Number: 162282
Place of Formation: IDAHO
File Number: 162282
Mailing Address: PO BOX 6033 POCATELLO, ID 83205-6033

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FACIAL & ORAL SURGERY ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2023 820311981 2024-11-07 FACIAL & ORAL SURGERY ASSOCIATES, P.A. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-10-01
Business code 621210
Sponsor’s telephone number 2082322807
Plan sponsor’s address PO BOX 6033, 165 NORTH 14TH, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2024-11-07
Name of individual signing MARK E BAKER
Valid signature Filed with authorized/valid electronic signature
FACIAL & ORAL SURGERY ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2022 820311981 2023-11-06 FACIAL & ORAL SURGERY ASSOCIATES, P.A. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-10-01
Business code 621210
Sponsor’s telephone number 2082322807
Plan sponsor’s address 165 NORTH 14TH, PO BOX 6033, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2023-11-06
Name of individual signing MARK E BAKER
Valid signature Filed with authorized/valid electronic signature
FACIAL & ORAL SURGERY ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2021 820311981 2023-01-10 FACIAL & ORAL SURGERY ASSOCIATES, P.A 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-10-01
Business code 621210
Sponsor’s telephone number 2082322807
Plan sponsor’s address 165 NORTH 14TH, PO BOX 6033, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2023-01-10
Name of individual signing MARK E BAKER
Valid signature Filed with authorized/valid electronic signature
FACIAL & ORAL SURGERY ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2020 820311981 2022-02-16 FACIAL & ORAL SURGERY ASSOCIATES, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-10-01
Business code 621210
Sponsor’s telephone number 2082322807
Plan sponsor’s address 165 NORTH 14TH, PO BOX 6033, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2022-02-16
Name of individual signing MARK E BAKER
Valid signature Filed with authorized/valid electronic signature
FACIAL & ORAL SURGERY ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2019 820311981 2021-06-21 FACIAL & ORAL SURGERY ASSOCIATES, P.A. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-10-01
Business code 621210
Sponsor’s telephone number 2082322807
Plan sponsor’s address 165 NORTH 14TH, PO BOX 6033, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2021-06-21
Name of individual signing MARK BAKER
Valid signature Filed with authorized/valid electronic signature
FACIAL & ORAL SURGERY ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2018 820311981 2020-04-01 FACIAL & ORAL SURGERY ASSOCIATES, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-10-01
Business code 621210
Sponsor’s telephone number 2082322807
Plan sponsor’s address 165 NORTH 14TH, PO BOX 6033, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2020-04-01
Name of individual signing MARK BAKER
Valid signature Filed with authorized/valid electronic signature
FACIAL & ORAL SURGERY ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2017 820311981 2019-03-12 FACIAL & ORAL SURGERY ASSOCIATES, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-10-01
Business code 621210
Sponsor’s telephone number 2082322807
Plan sponsor’s address 165 NORTH 14TH, PO BOX 6033, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2019-03-12
Name of individual signing MARK BAKER
Valid signature Filed with authorized/valid electronic signature
FACIAL & ORAL SURGERY ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2016 820311981 2018-07-09 FACIAL & ORAL SURGERY ASSOCIATES, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-10-01
Business code 621210
Sponsor’s telephone number 2082322807
Plan sponsor’s address 165 NORTH 14TH, PO BOX 6033, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2018-07-09
Name of individual signing MARK BAKER
Valid signature Filed with authorized/valid electronic signature
FACIAL & ORAL SURGERY ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2015 820311981 2017-07-17 FACIAL & ORAL SURGERY ASSOCIATES, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-10-01
Business code 621210
Sponsor’s telephone number 2082322807
Plan sponsor’s address 165 NORTH 14TH, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2017-07-17
Name of individual signing MARK BAKER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-17
Name of individual signing MARK BAKER
Valid signature Filed with authorized/valid electronic signature
FACIAL & ORAL SURGERY ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2014 820311981 2016-07-14 FACIAL & ORAL SURGERY ASSOCIATES, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-10-01
Business code 621210
Sponsor’s telephone number 2082322807
Plan sponsor’s address 165 NORTH 14TH, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2016-07-14
Name of individual signing MARK BAKER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-14
Name of individual signing MARK BAKER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MARK E BAKER Agent 165 N 14TH, POCATELLO, ID 83201

Vice President

Name Role Address Appointed On
Shawn A Jepsen Vice President 165 N 14TH AVE, POCATELLO, ID 83201 2023-09-21

President

Name Role Address Appointed On
MARK E BAKER President 165 N 14TH AVE, POCATELLO, ID 83201 2020-10-05

Filing

Filing Name Filing Number Filing date
Annual Report 0005876285 2024-09-03
Annual Report 0005408233 2023-09-21
Annual Report 0004920571 2022-09-20
Annual Report 0004435524 2021-10-04
Annual Report 0004023961 2020-10-05
Annual Report 0003657015 2019-10-29
Annual Report 0001557879 2018-09-12
Annual Report 0001557877 2017-08-31
Annual Report 0001557856 2016-11-21
Annual Report 0001557854 2015-09-09

Related by officers

MARK E BAKER

BAKER & JEPSEN, LLC

Shawn A Jepsen

BAKER & JEPSEN, LLC DENTAL ANESTHESIA CENTER AT FOSA, LLC

Related by address

PO BOX 6033 POCATELLO, ID 83205-6033

BAKER & JEPSEN, LLC DENTAL ANESTHESIA CENTER AT FOSA, LLC

Date of last update: 16 Jan 2025

Sources: Idaho Secretary of State

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