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  5. PHILIP W. GERVAIS, D.D.S., P.A.

PHILIP W. GERVAIS, D.D.S., P.A.

Company Details

Name: PHILIP W. GERVAIS, D.D.S., P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved
Date of registration: 13 Dec 1995 (29 years ago)
Financial Date End: 31 Dec 2015
Date dissolved: 14 Dec 2015
Entity Number: 347671
Place of Formation: IDAHO
File Number: 0000347671
ZIP code: 83864
County: Bonner County
Mailing Address: 2005 PINE ST SANDPOINT, ID 83864

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PHILIP W. GERVAIS, D.D.S., P.A. 401(K) PLAN 2015 820408361 2016-03-09 PHILIP W. GERVAIS, D.D.S., P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-10-01
Business code 621210
Sponsor’s telephone number 2082638535
Plan sponsor’s address 2005 WEST PINE STREET, SANDPOINT, ID, 838649327

Signature of
Role Plan administrator
Date 2016-03-09
Name of individual signing PHILIP W. GERVAIS, D.D.S.
Valid signature Filed with authorized/valid electronic signature
PHILIP W. GERVAIS, D.D.S., P.A. 401(K) PLAN 2014 820408361 2015-04-07 PHILIP W. GERVAIS, D.D.S., P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-10-01
Business code 621210
Sponsor’s telephone number 2082638535
Plan sponsor’s address 2005 WEST PINE STREET, SANDPOINT, ID, 838649327

Signature of
Role Plan administrator
Date 2015-04-07
Name of individual signing PHILIP W. GERVAIS, D.D.S.
Valid signature Filed with authorized/valid electronic signature
PHILIP W. GERVAIS, D.D.S., P.A. 401(K) PLAN 2013 820408361 2014-05-28 PHILIP W. GERVAIS, D.D.S., P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-10-01
Business code 621210
Sponsor’s telephone number 2082638535
Plan sponsor’s address 2005 WEST PINE STREET, SANDPOINT, ID, 838649327

Signature of
Role Plan administrator
Date 2014-05-28
Name of individual signing PHILIP W. GERVAIS, D.D.S.
Valid signature Filed with authorized/valid electronic signature
PHILIP W. GERVAIS, D.D.S., P.A. 401(K) PLAN 2012 820408361 2013-05-02 PHILIP W. GERVAIS, D.D.S., P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-10-01
Business code 621210
Sponsor’s telephone number 2082638535
Plan sponsor’s address 2005 WEST PINE STREET, SANDPOINT, ID, 838649327

Signature of
Role Plan administrator
Date 2013-05-01
Name of individual signing PHILIP W. GERVAIS, D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-01
Name of individual signing PHILIP W. GERVAIS, D.D.S.
Valid signature Filed with authorized/valid electronic signature
PHILIP W. GERVAIS, D.D.S., P.A. 401(K) PLAN 2011 820408361 2012-03-16 PHILIP W. GERVAIS, D.D.S., P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-10-01
Business code 621210
Sponsor’s telephone number 2082638535
Plan sponsor’s address 2005 WEST PINE STREET, SANDPOINT, ID, 838649327

Plan administrator’s name and address
Administrator’s EIN 820408361
Plan administrator’s name PHILIP W. GERVAIS, D.D.S., P.A.
Plan administrator’s address 2005 WEST PINE STREET, SANDPOINT, ID, 838649327
Administrator’s telephone number 2082638535

Signature of
Role Plan administrator
Date 2012-03-16
Name of individual signing PHILIP W. GERVAIS, D.D.S.
Valid signature Filed with authorized/valid electronic signature
PHILIP W. GERVAIS, D.D.S., P.A. 401(K) PLAN 2010 820408361 2011-07-11 PHILIP W. GERVAIS, D.D.S., P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-10-01
Business code 621210
Sponsor’s telephone number 2082638535
Plan sponsor’s address 2005 WEST PINE STREET, SANDPOINT, ID, 838649327

Plan administrator’s name and address
Administrator’s EIN 820408361
Plan administrator’s name PHILIP W. GERVAIS, D.D.S., P.A.
Plan administrator’s address 2005 WEST PINE STREET, SANDPOINT, ID, 838649327
Administrator’s telephone number 2082638535

Signature of
Role Plan administrator
Date 2011-07-11
Name of individual signing PHILIP W. GERVAIS, D.D.S.
Valid signature Filed with authorized/valid electronic signature
PHILIP W. GERVAIS, D.D.S., P.A. 401(K) PLAN 2010 820408361 2011-06-21 PHILIP W. GERVAIS, D.D.S., P.A. 7
Three-digit plan number (PN) 002
Effective date of plan 1999-10-01
Business code 621210
Sponsor’s telephone number 2082638535
Plan sponsor’s address 2005 WEST PINE STREET, SANDPOINT, ID, 838649327

Plan administrator’s name and address
Administrator’s EIN 820408361
Plan administrator’s name PHILIP W. GERVAIS, D.D.S., P.A.
Plan administrator’s address 2005 WEST PINE STREET, SANDPOINT, ID, 838649327
Administrator’s telephone number 2082638535

Signature of
Role Plan administrator
Date 2011-06-21
Name of individual signing PHILIP W. GERVAIS, D.D.S.
Valid signature Filed with incorrect/unrecognized electronic signature
PHILIP W. GERVAIS, D.D.S., P.A. 401(K) PLAN 2009 820408361 2010-08-24 PHILIP W. GERVAIS, D.D.S., P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-10-01
Business code 621210
Sponsor’s telephone number 2082638535
Plan sponsor’s address 2005 W. GERVAIS, D.D.S., P.A., SANDPOINT, ID, 838649327

Plan administrator’s name and address
Administrator’s EIN 820408361
Plan administrator’s name PHILIP W. GERVAIS, D.D.S., P.A.
Plan administrator’s address 2005 W. GERVAIS, D.D.S., P.A., SANDPOINT, ID, 838649327
Administrator’s telephone number 2082638535

Signature of
Role Plan administrator
Date 2010-08-24
Name of individual signing PHILIP W. GERVAIS
Valid signature Filed with authorized/valid electronic signature

Filing

Filing Name Filing Number Filing date
Articles of Dissolution 0000865707 2015-12-14
Annual Report 0002479127 2015-01-12
Annual Report 0002479126 2013-10-21
Annual Report 0002479124 2012-10-16
Annual Report 0002479119 2011-11-01
Annual Report 0002479118 2010-10-11
Annual Report 0002479117 2009-10-19
Annual Report 0002479121 2008-10-29
Annual Report 0002479120 2007-10-12
Annual Report 0002479112 2006-10-16

Related by officers

No related officers

Related by address

2005 PINE ST SANDPOINT, ID 83864

FORSBERG AND GERVAIS PROPERTIES LIMITED COMPANY RONALD W. FORSBERG, D.D.S., P.A. JD WILSON PROPERTIES, LLC

Date of last update: 25 Sep 2024

Sources: Idaho Secretary of State

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