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Lakeville Family Dental Centre, P.A.

Company Details

Name: Lakeville Family Dental Centre, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 03 Oct 1986 (38 years ago)
Company Number: 1f04e067-a9d4-e011-a886-001ec94ffe7f
File Number: 5I-1154
Registered Office Address: 16372 Kenrick Ave #200, Lakeville, MN 55044, USA
Principal Executive Office Address: 16372 KENRICK AVE STE 200, LAKEVILLE, MN 55044–3502, US
ZIP code: 55044
County: Dakota County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LAKEVILLE FAMILY DENTAL CENTRE, P.A. 401(K) PLAN 2023 411566598 2024-11-12 LAKEVILLE FAMILY DENTAL CENTRE, P.A. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 9524355905
Plan sponsor’s address 16372 KENRICK AVE #200, LAKEVILLE, MN, 550443502

Signature of

Role Plan administrator
Date 2024-11-12
Name of individual signing LIA BEDEAUX
Valid signature Filed with authorized/valid electronic signature
LAKEVILLE FAMILY DENTAL CENTRE, P.A. 401(K) PLAN 2023 411566598 2024-07-16 LAKEVILLE FAMILY DENTAL CENTRE, P.A. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 9524355905
Plan sponsor’s address 16372 KENRICK AVE #200, LAKEVILLE, MN, 550443502

Signature of

Role Plan administrator
Date 2024-07-16
Name of individual signing LIA BEDEAUX
Valid signature Filed with authorized/valid electronic signature
LAKEVILLE FAMILY DENTAL CENTRE, P.A. 401(K) PLAN 2022 411566598 2023-06-14 LAKEVILLE FAMILY DENTAL CENTRE, P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 9524355905
Plan sponsor’s address 16372 KENRICK AVE #200, LAKEVILLE, MN, 550443502

Signature of

Role Plan administrator
Date 2023-06-14
Name of individual signing LIA BEDEAUX
Valid signature Filed with authorized/valid electronic signature
LAKEVILLE FAMILY DENTAL CENTRE, P.A. 401(K) PLAN 2021 411566598 2022-07-19 LAKEVILLE FAMILY DENTAL CENTRE, P.A. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 9524355905
Plan sponsor’s address 16372 KENRICK AVE #200, LAKEVILLE, MN, 550443502

Chief Executive Officer

Name Role Address
Gary G Jenos Chief Executive Officer 16372 KENRICK AVE STE 200, LAKEVILLE, MN 55044–3502, US

Filing

Filing Name Filing date
Annual Reinstatement - Business Corporation (Domestic) 2023-05-31
Administrative Dissolution - Business Corporation (Domestic) 2023-01-26
Amendment - Business Corporation (Domestic) 1991-02-19
Registered Office and/or Agent - Business Corporation (Domestic) 1987-01-13
Original Filing - Business Corporation (Domestic) 1986-10-03
Business Corporation (Domestic) Business Name (Business Name: Lakeville Family Dental Centre, P.A.) 1986-10-03

Date of last update: 30 Sep 2024

Sources: Minnesota's Official State Website