M Gray Pond DMD LLC

Contacts

Phone	+1 205-631-3743

Authorized person

Name	MARGARET POND
Role	PRESIDENT
Phone	2056313743

Taxonomy

Taxonomy Code	261QD0000X - Dental Clinic/Center
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	2056313743
Plan sponsor’s address	1021 FULTON AVENUE, GARDENDALE, AL, 35071

Signature of

Role	Plan administrator
Date	2024-04-24
Name of individual signing	MAGGIE POND

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621210
Sponsor’s telephone number	2056313743
Plan sponsor’s address	1021 FULTON AVENUE, GARDENDALE, AL, 35071

Signature of

Role	Plan administrator
Date	2023-10-12
Name of individual signing	MAGGIE POND

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621210
Sponsor’s telephone number	2056313743
Plan sponsor’s address	1021 FULTON AVENUE, GARDENDALE, AL, 35071

Signature of

Role	Plan administrator
Date	2022-10-14
Name of individual signing	MAGGIE POND