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  5. MOSCOW FAMILY DENTISTRY, P.A.

MOSCOW FAMILY DENTISTRY, P.A.

Company Details

Name: MOSCOW FAMILY DENTISTRY, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 03 Apr 1995 (30 years ago)
Financial Date End: 30 Apr 2025
Entity Number: 339043
Place of Formation: IDAHO
File Number: 339043
ZIP code: 83843
County: Latah County
Mailing Address: 1215 E 6TH ST MOSCOW, ID 83843-3705

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MOSCOW FAMILY DENTISTRY, P.A. DEFINED BENEFIT PLAN 2023 820474654 2024-09-12 MOSCOW FAMILY DENTISTRY, P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2088826570
Plan sponsor’s address 1215 EAST 6TH STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2024-09-12
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-09-12
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY DENTISTRY, P.A. 401(K) PROFIT SHARING PLAN 2023 820474654 2024-09-12 MOSCOW FAMILY DENTISTRY, P.A. 28
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2088826570
Plan sponsor’s address 1215 EAST 6TH STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2024-09-12
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-09-12
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY DENTISTRY, P.A. DEFINED BENEFIT PLAN 2022 820474654 2023-10-06 MOSCOW FAMILY DENTISTRY, P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2088826570
Plan sponsor’s address 1215 EAST 6TH STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2023-10-06
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-06
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY DENTISTRY, P.A. 401(K) PROFIT SHARING PLAN 2022 820474654 2023-10-06 MOSCOW FAMILY DENTISTRY, P.A. 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2088826570
Plan sponsor’s address 1215 EAST 6TH STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2023-10-06
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-06
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY DENTISTRY, P.A. DEFINED BENEFIT PLAN 2021 820474654 2022-10-13 MOSCOW FAMILY DENTISTRY, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2088826570
Plan sponsor’s address 1215 EAST 6TH STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2022-10-13
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-13
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY DENTISTRY, P.A. 401(K) PROFIT SHARING PLAN 2021 820474654 2022-10-13 MOSCOW FAMILY DENTISTRY, P.A. 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2088826570
Plan sponsor’s address 1215 EAST 6TH STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2022-10-13
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-13
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY DENTISTRY, P.A. 401(K) PROFIT SHARING PLAN 2020 820474654 2021-09-27 MOSCOW FAMILY DENTISTRY, P.A. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2088826570
Plan sponsor’s address 1215 EAST 6TH STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2021-09-27
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-27
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY DENTISTRY, P.A. DEFINED BENEFIT PLAN 2020 820474654 2021-09-27 MOSCOW FAMILY DENTISTRY, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2088826570
Plan sponsor’s address 1215 EAST 6TH STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2021-09-27
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-27
Name of individual signing BENJAMIN BOWEN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY DENTISTRY, P.A. 401(K) PROFIT SHARING PLAN 2019 820474654 2020-10-14 MOSCOW FAMILY DENTISTRY, P.A. 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2088826570
Plan sponsor’s address 1215 E. 6TH STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2020-10-14
Name of individual signing BENJAMIN R. BOWEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-14
Name of individual signing BENJAMIN R. BOWEN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY DENTISTRY, P.A. DEFINED BENEFIT PLAN 2019 820474654 2020-10-14 MOSCOW FAMILY DENTISTRY, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2088826570
Plan sponsor’s address 1215 E. 6TH STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2020-10-14
Name of individual signing BENJAMIN R. BOWEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-14
Name of individual signing BENJAMIN R. BOWEN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BENJAMIN R BOWEN Agent 1215 6TH ST, MOSCOW, ID 83843

President

Name Role Address Appointed On
Benjamin Bowen President 1215 E 6TH STREET, MOSCOW, ID 83843 2021-02-03

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0005828116 2024-07-24
Dissolution/Revocation - Administrative 0005807117 2024-07-06
Annual Report 0005154272 2023-03-13
Application for Reinstatement 0005051492 2023-01-04
Dissolution/Revocation - Administrative 0004812928 2022-07-09
Annual Report 0004189562 2021-03-03
Application for Reinstatement 0004155618 2021-02-03
Dissolution/Revocation - Administrative 0003927155 2020-07-03
Annual Report 0003514106 2019-05-16
Annual Report 0002437121 2018-02-27

Related by officers

No related officers

Related by address

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Date of last update: 12 Dec 2024

Sources: Idaho Secretary of State

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