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  5. Dental Health Service of Northern Minnesota, P.A.

Dental Health Service of Northern Minnesota, P.A.

Company Details

Name: Dental Health Service of Northern Minnesota, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 31 Aug 1976 (48 years ago)
Company Number: 322140dc-a1d4-e011-a886-001ec94ffe7f
File Number: 2V-528
Registered Office Address: 411 E Howard Str, Hibbing, MN 55746, USA
Principal Executive Office Address: 802 W 42ND ST, HIBBING, MN 55746–3222, USA
ZIP code: 55746
County: St. Louis County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 401K PROFIT SHARING PLAN AND TRUST 2018 411239133 2019-07-14 DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 21
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 2182638381
Plan sponsor’s address 802 WEST 42ND STREET, HIBBING, MN, 55746

Signature of
Role Plan administrator
Date 2019-07-14
Name of individual signing NATHAN PEDERSEN
Valid signature Filed with authorized/valid electronic signature
DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 401K PROFIT SHARING PLAN AND TRUST 2017 411239133 2018-07-06 DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 23
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 2182638381
Plan sponsor’s address 802 WEST 42ND STREET, HIBBING, MN, 55746

Signature of
Role Plan administrator
Date 2018-07-06
Name of individual signing NATHAN PEDERSEN
Valid signature Filed with authorized/valid electronic signature
DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 401K PROFIT SHARING PLAN AND TRUST 2016 411239133 2017-07-12 DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 2182638381
Plan sponsor’s address 802 WEST 42ND STREET, HIBBING, MN, 55746

Signature of
Role Plan administrator
Date 2017-07-12
Name of individual signing NATHAN PEDERSEN
Valid signature Filed with authorized/valid electronic signature
DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 401K PROFIT SHARING PLAN AND TRUST 2015 411239133 2016-07-12 DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 20
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 2182638381
Plan sponsor’s address 802 WEST 42ND STREET, HIBBING, MN, 55746

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing NATHAN PEDERSEN
Valid signature Filed with authorized/valid electronic signature
DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 401K PROFIT SHARING PLAN AND TRUST 2014 411239133 2015-07-09 DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 22
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 2182638381
Plan sponsor’s address 802 WEST 42ND STREET, HIBBING, MN, 55746

Signature of
Role Plan administrator
Date 2015-07-09
Name of individual signing NATHAN PEDERSEN
Valid signature Filed with authorized/valid electronic signature
DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 401K PROFIT SHARING PLAN AND TRUST 2013 411239133 2014-07-16 DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 16
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 2182638381
Plan sponsor’s address 802 WEST 42ND STREET, HIBBING, MN, 55746

Signature of
Role Plan administrator
Date 2014-07-16
Name of individual signing NATHAN PEDERSEN
Valid signature Filed with authorized/valid electronic signature
DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 401K PROFIT SHARING PLAN AND TRUST 2012 411239133 2013-07-19 DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 16
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 2182638381
Plan sponsor’s address 411 EAST HOWARD STREET, HIBBING, MN, 55746

Signature of
Role Plan administrator
Date 2013-07-19
Name of individual signing NATHAN PEDERSEN
Valid signature Filed with authorized/valid electronic signature
DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 401K PROFIT SHARING PLAN AND TRUST 2011 411239133 2012-07-18 DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 15
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 2182638381
Plan sponsor’s address 411 EAST HOWARD STREET, HIBBING, MN, 55746

Plan administrator’s name and address
Administrator’s EIN 411239133
Plan administrator’s name DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A.
Plan administrator’s address 411 EAST HOWARD STREET, HIBBING, MN, 55746
Administrator’s telephone number 2182638381

Signature of
Role Plan administrator
Date 2012-07-18
Name of individual signing NATHAN PEDERSEN
Valid signature Filed with authorized/valid electronic signature
DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 401K PROFIT SHARING PLAN AND TRUST 2010 411239133 2011-07-22 DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 15
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 2182638381
Plan sponsor’s address 411 EAST HOWARD STREET, HIBBING, MN, 55746

Plan administrator’s name and address
Administrator’s EIN 411239133
Plan administrator’s name DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A.
Plan administrator’s address 411 EAST HOWARD STREET, HIBBING, MN, 55746
Administrator’s telephone number 2182638381

Signature of
Role Plan administrator
Date 2011-07-22
Name of individual signing NATHAN PEDERSEN
Valid signature Filed with authorized/valid electronic signature
DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 401K PROFIT SHARING PLAN AND TRUST 2009 411239133 2010-07-27 DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A. 17
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 2182638381
Plan sponsor’s address 411 EAST HOWARD STREET, HIBBING, MN, 55746

Plan administrator’s name and address
Administrator’s EIN 411239133
Plan administrator’s name DENTAL HEALTH SERVICE OF NORTHERN MINNESOTA P.A.
Plan administrator’s address 411 EAST HOWARD STREET, HIBBING, MN, 55746
Administrator’s telephone number 2182638381

Signature of
Role Plan administrator
Date 2010-07-27
Name of individual signing NATHAN PEDERSEN
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Nathan Pedersen Chief Executive Officer 802 W 42ND ST, HIBBING, MN 55746–3222, USA

Filing

Filing Name Filing date
Business Corporation (Domestic) Active Status Report 1980-08-15
Original Filing - Business Corporation (Domestic) (Business Name: Dental Health Service of Northern Minnesota, P.A.) 1976-08-31

Related by officers

No related officers

Related by address

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Date of last update: 01 Oct 2024

Sources: Minnesota's Official State Website

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