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  5. AVONDALE DENTAL CENTER LLC

AVONDALE DENTAL CENTER LLC

Company Details

Name: AVONDALE DENTAL CENTER LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 04 Sep 2008 (17 years ago)
Financial Date End: 30 Sep 2025
Entity Number: 242383
Place of Formation: IDAHO
File Number: 242383
ZIP code: 83835
County: Kootenai County
Principal Address: 1683 E MILES AVE HAYDEN, ID 83835
Mailing Address: 1015 W IRONWOOD DR COEUR D ALENE COEUR D'ALENE, ID 83814

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AVONDALE DENTAL CENTER 401(K) PLAN 2023 263429569 2024-07-29 AVONDALE DENTAL CENTER, LLC 95
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 2087724066
Plan sponsor’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835

Plan administrator’s name and address
Administrator’s EIN 263429569
Plan administrator’s name AVONDALE DENTAL CENTER, LLC
Plan administrator’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835
Administrator’s telephone number 2087724066
AVONDALE DENTAL CENTER 401(K) PLAN 2022 263429569 2023-10-09 AVONDALE DENTAL CENTER, LLC 85
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 2087724066
Plan sponsor’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835

Plan administrator’s name and address
Administrator’s EIN 263429569
Plan administrator’s name AVONDALE DENTAL CENTER, LLC
Plan administrator’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835
Administrator’s telephone number 2087724066
AVONDALE DENTAL CENTER 401(K) PLAN 2021 263429569 2022-10-11 AVONDALE DENTAL CENTER, LLC 57
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 2087724066
Plan sponsor’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835

Plan administrator’s name and address
Administrator’s EIN 263429569
Plan administrator’s name AVONDALE DENTAL CENTER, LLC
Plan administrator’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835
Administrator’s telephone number 2087724066
AVONDALE DENTAL CENTER 401(K) PLAN 2020 263429569 2021-09-30 AVONDALE DENTAL CENTER, LLC 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 2087724066
Plan sponsor’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835

Plan administrator’s name and address
Administrator’s EIN 263429569
Plan administrator’s name AVONDALE DENTAL CENTER, LLC
Plan administrator’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835
Administrator’s telephone number 2087724066
AVONDALE DENTAL CENTER 401(K) PLAN 2019 263429569 2020-06-16 AVONDALE DENTAL CENTER, LLC 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 2087724066
Plan sponsor’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835

Plan administrator’s name and address
Administrator’s EIN 263429569
Plan administrator’s name AVONDALE DENTAL CENTER, LLC
Plan administrator’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835
Administrator’s telephone number 2087724066
AVONDALE DENTAL CENTER 401(K) PLAN 2018 263429569 2019-03-15 AVONDALE DENTAL CENTER, LLC 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 2087724066
Plan sponsor’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835

Plan administrator’s name and address
Administrator’s EIN 263429569
Plan administrator’s name AVONDALE DENTAL CENTER, LLC
Plan administrator’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835
Administrator’s telephone number 2087724066
AVONDALE DENTAL CENTER 401(K) PLAN 2017 263429569 2018-04-09 AVONDALE DENTAL CENTER, LLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 2087724066
Plan sponsor’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835

Plan administrator’s name and address
Administrator’s EIN 263429569
Plan administrator’s name AVONDALE DENTAL CENTER, LLC
Plan administrator’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835
Administrator’s telephone number 2087724066
AVONDALE DENTAL CENTER 401(K) PLAN 2016 263429569 2017-02-21 AVONDALE DENTAL CENTER, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 2087724066
Plan sponsor’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835

Plan administrator’s name and address
Administrator’s EIN 263429569
Plan administrator’s name AVONDALE DENTAL CENTER, LLC
Plan administrator’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835
Administrator’s telephone number 2087724066
AVONDALE DENTAL CENTER 401(K) PLAN 2015 263429569 2016-06-30 AVONDALE DENTAL CENTER, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 2087724066
Plan sponsor’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835

Plan administrator’s name and address
Administrator’s EIN 263429569
Plan administrator’s name AVONDALE DENTAL CENTER, LLC
Plan administrator’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835
Administrator’s telephone number 2087724066
AVONDALE DENTAL CENTER 401(K) PLAN 2014 263429569 2015-04-06 AVONDALE DENTAL CENTER, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 2087724066
Plan sponsor’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835

Plan administrator’s name and address
Administrator’s EIN 263429569
Plan administrator’s name AVONDALE DENTAL CENTER, LLC
Plan administrator’s address 1683 E. MILES AVENUE, HAYDEN, ID, 83835
Administrator’s telephone number 2087724066

Signature of
Role Plan administrator
Date 2015-04-06
Name of individual signing KORY WILSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
KORY J WILSON DDS Agent 1683 E MILES AVE, HAYDEN, ID 83835

Manager

Name Role Address Appointed On
Kory Wilson Manager 1683 E MILES AVE, HAYDEN, ID 83835 2020-08-03

Filing

Filing Name Filing Number Filing date
Annual Report 0005840384 2024-08-05
Annual Report 0005345877 2023-08-03
Annual Report 0004845294 2022-08-04
Annual Report 0004367379 2021-08-03
Annual Report 0003953400 2020-08-03
Annual Report 0003627114 2019-09-23
Application for Reinstatement 0001904613 2018-01-10
Application for Reinstatement 0000816756 2018-01-02
Annual Report 0001904612 2016-08-06
Annual Report 0001904614 2015-07-20

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6370907009 2020-04-06 1094 PPP 1683 E MILES AVE, HAYDEN, ID, 83835-9109
Loan Status Date 2021-04-08
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 454802
Loan Approval Amount (current) 454802
Undisbursed Amount 0
Franchise Name -
Lender Location ID 87893
Servicing Lender Name Glacier Bank
Servicing Lender Address 202 Main St, KALISPELL, MT, 59901-4454
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address HAYDEN, KOOTENAI, ID, 83835-9109
Project Congressional District ID-01
Number of Employees 36
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 87893
Originating Lender Name Glacier Bank
Originating Lender Address KALISPELL, MT
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 458876.53
Forgiveness Paid Date 2021-03-11

Related by officers

Kory Wilson

NORTH IDAHO COLLEGE FOUNDATION, INC. WILSON, D.D.S., L.L.C. CARLIN BAY CABIN, LLC EAG PROPERTIES, LLC NORTHWEST DENTAL BENEFITS, LLC ICM ETHANOL, INC.

Related by address

1683 E MILES AVE HAYDEN, ID 83835

ELEMENT DENTAL AVONDALE DENTAL AVONDALE DENTAL GROUP

Date of last update: 02 Apr 2025

Sources: Idaho Secretary of State

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