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  5. PREMIER DENTAL CARE, P.C.

PREMIER DENTAL CARE, P.C.

Company Details

Name: PREMIER DENTAL CARE, P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved
Date of registration: 22 Dec 1998 (26 years ago)
Date dissolved: 13 Feb 2019
Entity Number: 388171
Place of Formation: IDAHO
File Number: 0000388171
ZIP code: 83404
County: Bonneville County
Mailing Address: 2685 CHANNING WAY IDAHO FALLS, ID 83404

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PREMIER DENTAL CARE, P.C. RETIREMENT PLAN 2017 820510132 2018-06-11 PREMIER DENTAL CARE, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2085244746
Plan sponsor’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 820510132
Plan administrator’s name PREMIER DENTAL CARE, P.C.
Plan administrator’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085244746
PREMIER DENTAL CARE, P.C. RETIREMENT PLAN 2016 820510132 2017-10-16 PREMIER DENTAL CARE, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2085244746
Plan sponsor’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 820510132
Plan administrator’s name PREMIER DENTAL CARE, P.C.
Plan administrator’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085244746
PREMIER DENTAL CARE, P.C. RETIREMENT PLAN 2015 820510132 2016-10-17 PREMIER DENTAL CARE, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2085244746
Plan sponsor’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 820510132
Plan administrator’s name PREMIER DENTAL CARE, P.C.
Plan administrator’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085244746
PREMIER DENTAL CARE, P.C. RETIREMENT PLAN 2014 820510132 2015-10-08 PREMIER DENTAL CARE, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2085244746
Plan sponsor’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 820510132
Plan administrator’s name PREMIER DENTAL CARE, P.C.
Plan administrator’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085244746

Signature of
Role Plan administrator
Date 2015-10-08
Name of individual signing THOMAS T. ANDERSON
Valid signature Filed with authorized/valid electronic signature
PREMIER DENTAL CARE, P.C. RETIREMENT PLAN 2013 820510132 2014-09-12 PREMIER DENTAL CARE, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2085244746
Plan sponsor’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 820510132
Plan administrator’s name PREMIER DENTAL CARE, P.C.
Plan administrator’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085244746

Signature of
Role Plan administrator
Date 2014-09-12
Name of individual signing THOMAS T. ANDERSON
Valid signature Filed with authorized/valid electronic signature
PREMIER DENTAL CARE, P.C. RETIREMENT PLAN 2012 820510132 2013-10-01 PREMIER DENTAL CARE, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2085244746
Plan sponsor’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 820510132
Plan administrator’s name PREMIER DENTAL CARE, P.C.
Plan administrator’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085244746

Signature of
Role Plan administrator
Date 2013-10-01
Name of individual signing THOMAS T. ANDERSON
Valid signature Filed with authorized/valid electronic signature
PREMIER DENTAL CARE, P.C. RETIREMENT PLAN 2012 820510132 2013-08-09 PREMIER DENTAL CARE, P.C. 5
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2085244746
Plan sponsor’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 820510132
Plan administrator’s name PREMIER DENTAL CARE, P.C.
Plan administrator’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085244746

Signature of
Role Plan administrator
Date 2013-08-09
Name of individual signing THOMAS T. ANDERSON
Valid signature Filed with authorized/valid electronic signature
PREMIER DENTAL CARE, P.C. RETIREMENT PLAN 2011 820510132 2012-10-15 PREMIER DENTAL CARE, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2085244746
Plan sponsor’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 820510132
Plan administrator’s name PREMIER DENTAL CARE, P.C.
Plan administrator’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085244746

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing THOMAS T. ANDERSON
Valid signature Filed with authorized/valid electronic signature
PREMIER DENTAL CARE, P.C. RETIREMENT PLAN 2010 820510132 2011-10-11 PREMIER DENTAL CARE, P.C. 4
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2085244746
Plan sponsor’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 820510132
Plan administrator’s name PREMIER DENTAL CARE, P.C.
Plan administrator’s address 2685 CHANNING WAY, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085244746

Signature of
Role Plan administrator
Date 2011-10-10
Name of individual signing THOMAS T. ANDERSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
THOMAS T. ANDERSON Agent 2685 CHANNING WAY, IDAHO FALLS, ID 83404

Filing

Filing Name Filing Number Filing date
Articles of Dissolution 0003429005 2019-02-13
Annual Report 0002665382 2017-11-13
Annual Report 0002665381 2016-11-22
Annual Report 0002665380 2015-11-08
Annual Report 0002665379 2015-01-08
Annual Report 0002665377 2013-10-24
Annual Report 0002665376 2012-11-12
Annual Report 0002665373 2011-11-15
Annual Report 0002665372 2010-11-19
Annual Report 0002665371 2009-11-04

Related by officers

No related officers

Related by address

2685 CHANNING WAY IDAHO FALLS, ID 83404

IDAHO CENTER FOR SEDATION IDAHO DENTAL PARTNERS PLLC GRIN PLLC

Date of last update: 25 Sep 2024

Sources: Idaho Secretary of State

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