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Clairmont Cosmetic & Family Dentistry, LLC

Details

Name: Clairmont Cosmetic & Family Dentistry, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 22 Dec 1999 (25 years ago)
Entity Number: 000-667-773
Register Number: 000667773
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 1819 5TH AVENUE NORTHBIRMINGHAM, AL 35203
Registered Office Street Address ZIP Code: 35203

Activities DENTAL SERVICES

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLAIRMONT COSMETIC & FAMILY DENTISTRY 401(K) PROFIT SHARING PLAN 2016 631239719 2017-07-18 CLAIRMONT COSMETIC & FAMILY DENTISTRY, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2053268060
Plan sponsor’s address 716 32ND ST, BIRMINGHAM, AL, 352333500

Signature of
Role Plan administrator
Date 2017-07-18
Name of individual signing STACEY CHOAT
Role Employer/plan sponsor
Date 2017-07-18
Name of individual signing STACEY CHOAT
CLAIRMONT COSMETIC & FAMILY DENTISTRY 401(K) PROFIT SHARING PLAN 2016 631239719 2017-10-03 CLAIRMONT COSMETIC & FAMILY DENTISTRY, LLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2053268060
Plan sponsor’s address 716 32ND ST, BIRMINGHAM, AL, 352333500

Signature of
Role Plan administrator
Date 2017-10-03
Name of individual signing STACEY CHOAT
Role Employer/plan sponsor
Date 2017-10-03
Name of individual signing STACEY CHOAT
CLAIRMONT COSMETIC & FAMILY DENTISTRY 401(K) PROFIT SHARING PLAN 2015 631239719 2016-07-13 CLAIRMONT COSMETIC & FAMILY DENTISTRY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2053268060
Plan sponsor’s address 716 32ND ST, BIRMINGHAM, AL, 352333500

Signature of
Role Plan administrator
Date 2016-07-13
Name of individual signing STACEY CHOAT
Role Employer/plan sponsor
Date 2016-07-13
Name of individual signing STACEY CHOAT
CLAIRMONT COSMETIC & FAMILY DENTISTRY 401(K) PROFIT SHARING PLAN 2014 631239719 2015-06-29 CLAIRMONT COSMETIC & FAMILY DENTISTRY, LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2053268060
Plan sponsor’s address 716 32ND ST, BIRMINGHAM, AL, 352333500

Signature of
Role Plan administrator
Date 2015-06-29
Name of individual signing STACEY CHOAT
Role Employer/plan sponsor
Date 2015-06-29
Name of individual signing STACEY CHOAT
CLAIRMONT COSMETIC & FAMILY DENTISTRY 401(K) PROFIT SHARING PLAN 2013 631239719 2014-07-24 CLAIRMONT COSMETIC & FAMILY DENTISTRY, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2053268060
Plan sponsor’s address 716 32ND ST, BIRMINGHAM, AL, 352333500

Signature of
Role Plan administrator
Date 2014-07-24
Name of individual signing STACEY CHOAT
Role Employer/plan sponsor
Date 2014-07-24
Name of individual signing STACEY CHOAT
CLAIRMONT COSMETIC & FAMILY DENTISTRY 401(K) PROFIT SHARING PLAN 2012 631239719 2013-10-04 CLAIRMONT COSMETIC & FAMILY DENTISTRY 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2053268060
Plan sponsor’s address 716 32ND STREET SOUTH, BIRMINGHAM, AL, 35233

Signature of
Role Plan administrator
Date 2013-10-04
Name of individual signing STEPHEN PAK
Role Employer/plan sponsor
Date 2013-10-04
Name of individual signing STEPHEN PAK
CLAIRMONT COSMETIC & FAMILY DENTISTRY 401(K) & PROFIT SHARING PLAN 2011 631239719 2013-09-26 CLAIRMONT COSMETIC & FAMILY DENTISTRY 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2053268060
Plan sponsor’s address 716 32ND STREET SOUTH, BIRMINGHAM, AL, 35233

Plan administrator’s name and address
Administrator’s EIN 631239719
Plan administrator’s name CLAIRMONT COSMETIC & FAMILY DENTISTRY
Plan administrator’s address 716 32ND STREET SOUTH, BIRMINGHAM, AL, 35233
Administrator’s telephone number 2053268060

Signature of
Role Plan administrator
Date 2013-09-26
Name of individual signing STEPHEN PAK
Role Employer/plan sponsor
Date 2013-09-26
Name of individual signing STEPHEN PAK

Agent

Name Role Address
PAK, STEPHEN H Agent 716 32ND STREET SOUTHBIRMINGHAM, AL 35233

Member

Name Role Address
PAK, STEPHEN H Member 716 32ND STREET SOUTHBIRMINGHAM, AL 35233

Related by officers

PAK, STEPHEN H

American Dental Group, LLC Clairmont Dental Management Group, LLC PAK Properties, LLC

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1819 5TH AVENUE NORTHBIRMINGHAM, AL 35203

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Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State

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