| Name: | PERIODONTAL HEALTH SPECIALISTS OF IDAHO |
| Jurisdiction: | Idaho |
| Legal type: | Assumed Business Name |
| Status: | Active-Current |
| Date of registration: | 31 Jul 2014 (10 years ago) |
| Entity Number: | 523603 |
| Place of Formation: | IDAHO |
| File Number: | 0000523603 |
| Mailing Address: | 140 E BOISE AVE BOISE, ID 83706-4373 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PERIODONTAL HEALTH SPECIALISTS OF IDAHO 401(K) SHARING PLAN | 2022 | 471378590 | 2023-07-26 | PERIODONTAL HEALTH SPECIALISTS OF IDAHO | 26 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2023-07-26 |
| Name of individual signing | JACK LINCKS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1989-10-28 |
| Business code | 621210 |
| Sponsor’s telephone number | 2083859228 |
| Plan sponsor’s address | 140 EAST BOISE AVENUE, BOISE, ID, 83706 |
Signature of
| Role | Plan administrator |
| Date | 2022-10-13 |
| Name of individual signing | JACK LINCKS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1989-10-28 |
| Business code | 621210 |
| Sponsor’s telephone number | 2083859228 |
| Plan sponsor’s address | 140 EAST BOISE AVENUE, BOISE, ID, 83706 |
Signature of
| Role | Plan administrator |
| Date | 2021-10-11 |
| Name of individual signing | JACK LINCKS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1989-10-28 |
| Business code | 621210 |
| Sponsor’s telephone number | 2083859228 |
| Plan sponsor’s address | 140 EAST BOISE AVENUE, BOISE, ID, 83706 |
Signature of
| Role | Plan administrator |
| Date | 2020-09-23 |
| Name of individual signing | JACK LINCKS |
| Valid signature | Filed with authorized/valid electronic signature |
| Filing Name | Filing Number | Filing date |
|---|---|---|
| Amendment of Certificate of Assumed Business Name | 0003628255 | 2019-09-25 |
| Amendment of Certificate of Assumed Business Name | 0003591248 | 2019-08-08 |
| Amendment of Mailing Address for Certificate of Assumed Business Name | 0003591238 | 2019-08-08 |
| Initial Filing | 0000523603 | 2014-07-31 |
Date of last update: 26 Sep 2024
Sources: Idaho Secretary of State
