| Name: | The Pediatric Dental Clinic LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 13 May 2020 (5 years ago) (Companies founded in May 2020) |
| Entity Number: | 000-631-147 |
| Register Number: | 000631147 |
| ZIP code: | 35802 (Companies in Madison, 35802) |
| County: | Madison |
| Place of Formation: | Madison County |
| Registered Office Street Address: | 600 BLVD SOUTH SW STE 104JHUNTSVILLE, AL 35802 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861996035 | 2018-03-21 | 2018-03-21 | 162 ANA DR, FLORENCE, AL, 356301759, US | 162 ANA DR, FLORENCE, AL, 356301759, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 256-766-0270 |
| Fax | 2567668328 |
Authorized person
| Name | DAVID MERRITT |
| Role | DR. |
| Phone | 2567660270 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| License Number | 3267 |
| State | AL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THE PEDIATRIC DENTAL CLINIC LLC 401(K) PLAN | 2023 | 851118166 | 2024-05-15 | THE PEDIATRIC DENTAL CLINIC LLC | 14 | |||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-15 |
| Name of individual signing | QIAN LIU |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2567660270 |
| Plan sponsor’s address | 162 ANA DR, FLORENCE, AL, 35630 |
Plan administrator’s name and address
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-27 |
| Name of individual signing | CHRISTINE RIMER |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2567660270 |
| Plan sponsor’s address | 162 ANA DR, FLORENCE, AL, 35630 |
Plan administrator’s name and address
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2022-05-19 |
| Name of individual signing | CHRISTINE RIMER |
| Name | Role | Address |
|---|---|---|
| USCA INC | Agent | 101 N BRAND BLVD 11TH FLGLENDALE, CA 91203 |
| Name | Role | Address |
|---|---|---|
| LEGALZOOM.COM INC | Organizer | 101 N BRAND BLVD 10TH FLOORGLENDALE, CA 91203 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
