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THOMAS L BLAISDELL DDS PC

Company Details

Name: THOMAS L BLAISDELL DDS PC
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 18 Jul 2007 (18 years ago)
Financial Date End: 31 Jul 2025
Entity Number: 527499
Place of Formation: IDAHO
File Number: 527499
ZIP code: 83605
County: Canyon County
Mailing Address: 3611 S 10TH AVE CALDWELL, ID 83605-6209

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2023 260845729 2024-09-16 THOMAS L. BLAISDELL DDS PC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of

Role Plan administrator
Date 2024-09-16
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2022 260845729 2023-08-07 THOMAS L. BLAISDELL DDS PC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of

Role Plan administrator
Date 2023-08-07
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2021 260845729 2022-10-03 THOMAS L. BLAISDELL DDS PC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of

Role Plan administrator
Date 2022-10-03
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2020 260845729 2021-10-11 THOMAS L. BLAISDELL DDS PC 8
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of

Role Plan administrator
Date 2021-10-11
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2020 260845729 2023-01-16 THOMAS L. BLAISDELL DDS PC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of

Role Plan administrator
Date 2023-01-16
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2019 260845729 2020-09-23 THOMAS L. BLAISDELL DDS PC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of

Role Plan administrator
Date 2020-09-23
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2018 260845729 2019-10-08 THOMAS L. BLAISDELL DDS PC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of

Role Plan administrator
Date 2019-10-08
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2017 260845729 2018-09-13 THOMAS L. BLAISDELL DDS PC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of

Role Plan administrator
Date 2018-09-13
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2016 260845729 2017-08-31 THOMAS L. BLAISDELL DDS PC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 1916 ELLIS AVE., CALDWELL, ID, 83605

Signature of

Role Plan administrator
Date 2017-08-31
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2015 260845729 2016-09-21 THOMAS L. BLAISDELL DDS PC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 1916 ELLIS AVE., CALDWELL, ID, 83605

Signature of

Role Plan administrator
Date 2016-09-21
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
THOMAS L BLAISDELL Agent 3611 S 10TH AVE, TOM BLAISDELL, CALDWELL, ID 83605

President

Name Role Address Appointed On
THOMAS BLAISDELL President 3611 S 10TH AVE, CALDWELL, ID 83605 2020-08-05

Secretary

Name Role Address Appointed On
Sheri Blaisdell Secretary 3611 S 10TH AVE, CALDWELL, ID 83605 2023-06-13

Filing

Filing Name Filing Number Filing date
Annual Report 0005759469 2024-06-04
Annual Report 0005279174 2023-06-13
Annual Report 0004774662 2022-06-07
Annual Report 0004322242 2021-06-22
Annual Report 0003959741 2020-08-05
Annual Report 0003550788 2019-06-25
Annual Report 0003132626 2018-05-29
Annual Report 0003132624 2017-07-05
Annual Report 0003132623 2016-06-21
Annual Report 0003132622 2015-05-20

Date of last update: 24 Dec 2024

Sources: Idaho Secretary of State