| Name: | Table Rock Oral Surgery PLLC |
| Jurisdiction: | Idaho |
| Legal type: | Limited Liability Company (D) |
| Status: | Active-Existing |
| Date of registration: | 02 May 2021 (4 years ago) |
| Financial Date End: | 31 May 2025 |
| Entity Number: | 4261215 |
| Place of Formation: | IDAHO |
| File Number: | 761456 |
| ZIP code: | 83702 |
| County: | Ada County |
| Principal Address: | STE 320 403 S 11TH STREET BOISE, ID 83702 |
| Mailing Address: | STE 320 403 S 11TH ST BOISE, ID 83702-6968 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TABLE ROCK ORAL SURGERY 401(K) PLAN | 2023 | 863622119 | 2024-07-09 | TABLE ROCK ORAL SURGERY | 9 | |||||||||||||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2024-07-09 |
| Name of individual signing | TIMOTHY OBRIEN |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-07-09 |
| Name of individual signing | TIMOTHY OBRIEN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Timothy OBrien | Agent | 403 S 11TH ST, # 320, BOISE, ID 83702 |
| Name | Role | Address | Appointed On |
|---|---|---|---|
| Timothy OBrien | Member | 5350 E SOFTWOOD CT, BOISE, ID 83716 | 2022-05-04 |
| Name | Role | Address | Appointed On |
|---|---|---|---|
| Timothy OBrien | Manager | 5350 E SOFTWOOD CT, BOISE, ID 83716 | 2024-04-22 |
| Filing Name | Filing Number | Filing date |
|---|---|---|
| Annual Report | 0005699970 | 2024-04-22 |
| Application for Reinstatement | 0005351582 | 2023-08-04 |
| Dissolution/Revocation - Administrative | 0005349590 | 2023-08-04 |
| Annual Report | 0004733059 | 2022-05-04 |
| Initial Filing | 0004261215 | 2021-05-02 |
Date of last update: 04 Jan 2025
Sources: Idaho Secretary of State
