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  5. South Suburban Oral and Maxillofacial Surgeons, Ltd.

South Suburban Oral and Maxillofacial Surgeons, Ltd.

Company Details

Name: South Suburban Oral and Maxillofacial Surgeons, Ltd.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 11 May 1993 (32 years ago)
Company Number: 417aa844-a3d4-e011-a886-001ec94ffe7f
File Number: 7U-836
Registered Office Address: 625 E Nicollet Blvd #205, Burnsville, MN 55337, USA
Principal Executive Office Address: 625 East Nicollet Boulevard, Suite 205, Burnsville, MN 55337, USA
ZIP code: 55337
County: Dakota County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD PROFIT SHARING PLAN 2014 411749104 2015-03-25 SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-04-01
Business code 621111
Sponsor’s telephone number 9524350310
Plan sponsor’s address 625 E. NICOLLET BOULEVARD, STE 205, BURNSVILLE, MN, 55337

Signature of
Role Plan administrator
Date 2015-03-25
Name of individual signing LARRY PALMERSHEIM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-03-25
Name of individual signing LARRY PALMERSHEIM
Valid signature Filed with authorized/valid electronic signature
SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD PROFIT SHARING PLAN 2013 411749104 2014-09-02 SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-04-01
Business code 621111
Sponsor’s telephone number 9524350310
Plan sponsor’s address 625 E. NICOLLET BOULEVARD, STE 205, BURNSVILLE, MN, 55337

Signature of
Role Plan administrator
Date 2014-08-29
Name of individual signing LAWRENCE A PALMERSHEIM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-08-29
Name of individual signing LAWRENCE A PALMERSHEIM
Valid signature Filed with authorized/valid electronic signature
SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD PROFIT SHARING PLAN 2012 411749104 2013-09-18 SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-04-01
Business code 621111
Sponsor’s telephone number 9524350310
Plan sponsor’s address 625 E. NICOLLET BOULEVARD, STE 205, BURNSVILLE, MN, 55337

Signature of
Role Plan administrator
Date 2013-09-17
Name of individual signing LAWRENCE PALMERSHEIM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-17
Name of individual signing LAWRENCE PALMERSHEIM
Valid signature Filed with authorized/valid electronic signature
SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD PROFIT SHARING PLAN 2011 411749104 2012-09-28 SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-04-01
Business code 621111
Sponsor’s telephone number 9524350310
Plan sponsor’s address 625 E. NICOLLET BOULEVARD, STE 205, BURNSVILLE, MN, 55337

Plan administrator’s name and address
Administrator’s EIN 411749104
Plan administrator’s name SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD.
Plan administrator’s address 625 E. NICOLLET BOULEVARD, STE 205, BURNSVILLE, MN, 55337
Administrator’s telephone number 9524350310

Signature of
Role Plan administrator
Date 2012-09-27
Name of individual signing LAWRENCE PALMERSHEIM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-27
Name of individual signing LAWRENCE PALMERSHEIM
Valid signature Filed with authorized/valid electronic signature
SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD PROFIT SHARING PLAN 2010 411749104 2011-09-01 SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD. 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-04-01
Business code 621111
Sponsor’s telephone number 9524350310
Plan sponsor’s address 625 E. NICOLLET BOULEVARD, STE 205, BURNSVILLE, MN, 55337

Plan administrator’s name and address
Administrator’s EIN 411749104
Plan administrator’s name SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD.
Plan administrator’s address 625 E. NICOLLET BOULEVARD, STE 205, BURNSVILLE, MN, 55337
Administrator’s telephone number 9524350310

Signature of
Role Plan administrator
Date 2011-09-01
Name of individual signing LAWRENCE PALMERSHEIM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-01
Name of individual signing LAWRENCE PALMERSHEIM
Valid signature Filed with authorized/valid electronic signature
SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD PROFIT SHARING PLAN 2009 411749104 2010-10-06 SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-04-01
Business code 621111
Sponsor’s telephone number 9524350310
Plan sponsor’s address 625 E. NICOLLET BOULEVARD, STE 205, BURNSVILLE, MN, 55337

Plan administrator’s name and address
Administrator’s EIN 411749104
Plan administrator’s name SOUTH SUBURBAN ORAL AND MAXILLOFACIAL SURGEONS, LTD.
Plan administrator’s address 625 E. NICOLLET BOULEVARD, STE 205, BURNSVILLE, MN, 55337
Administrator’s telephone number 9524350310

Signature of
Role Plan administrator
Date 2010-10-06
Name of individual signing LAWRENCE PALMERSHEIM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-06
Name of individual signing LAWRENCE PALMERSHEIM
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Mark Roszkowski Chief Executive Officer 625 East Nicollet Boulevard, Suite 205, Burnsville, MN 55337, USA

Filing

Filing Name Filing date
Annual Reinstatement - Business Corporation (Domestic) 2017-07-19
Administrative Dissolution - Business Corporation (Domestic) 2017-02-27
Business Corporation (Domestic) Business Name (Business Name: South Suburban Oral and Maxillofacial Surgeons, Ltd.) 2000-10-24
Business Corporation (Domestic) Business Name (Business Name: South Suburban Oral and Maxillofacial Surgeons, P.A.) 1999-10-01
Registered Office and/or Agent - Business Corporation (Domestic) 1993-11-12
Amendment - Business Corporation (Domestic) 1993-06-11
Original Filing - Business Corporation (Domestic) 1993-05-11
Business Corporation (Domestic) Business Name (Business Name: Lawrence A. Palmersheim, D.D.S., P.A.) 1993-05-11

Related by officers

Mark Roszkowski

Northern Lights Dental Forum, Inc.

Related by address

625 E Nicollet Blvd #205, Burnsville, MN 55337, USA

Northern Lights Dental Forum, Inc. SOUTH SUBURBAN OMS South Suburban Oral Surgery

Date of last update: 03 Oct 2024

Sources: Minnesota's Official State Website

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