King Dental, LLC

Contacts

Phone	+1 256-880-1884

Authorized person

Name	BEVERLY HOLCOMB
Role	CREDENTIALING
Phone	2568801884

Taxonomy

Taxonomy Code	122300000X - Dentist
Is Primary	Yes

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621210
Sponsor’s telephone number	2568801884
Plan sponsor’s address	1108 GLENEAGLES DR, HUNTSVILLE, AL, 35806

Signature of

Role	Plan administrator
Date	2024-10-03
Name of individual signing	ALLISON BRECHER
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621210
Sponsor’s telephone number	2568801884
Plan sponsor’s address	1108 GLENEAGLES DR, HUNTSVILLE, AL, 35806

Signature of

Role	Plan administrator
Date	2023-10-12
Name of individual signing	ALLISON BRECHER

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621210
Sponsor’s telephone number	2568801884
Plan sponsor’s address	1108 GLENEAGLES DR, HUNTSVILLE, AL, 35806

Signature of

Role	Plan administrator
Date	2022-10-07
Name of individual signing	ALLISON BRECHER