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  5. Crystal Lake Dental Care of Robbinsdale PLLC

Crystal Lake Dental Care of Robbinsdale PLLC

Company Details

Name: Crystal Lake Dental Care of Robbinsdale PLLC
Jurisdiction: Minnesota
Legal type: Limited Liability Company (Domestic)
Status: Inactive
Date formed: 14 Oct 2004 (20 years ago)
Company Number: 7d7cc734-89d4-e011-a886-001ec94ffe7f
File Number: 1057174-2
Registered Office Address: 3925 37th Ave N, Robbinsdale, MN 55422, USA
ZIP code: 55422
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE 401(K) PLAN 2019 201390452 2020-12-14 CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 7635888426
Plan sponsor’s address 3925 37TH AVENUE NORTH, ROBBINSDALE, MN, 55422

Signature of
Role Plan administrator
Date 2020-12-11
Name of individual signing JAMES R GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-12-11
Name of individual signing JAMES R GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE 401(K) PLAN 2019 201390452 2020-06-04 CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 7635888426
Plan sponsor’s address 3925 37TH AVENUE NORTH, ROBBINSDALE, MN, 55422

Signature of
Role Plan administrator
Date 2020-06-04
Name of individual signing JAMES R GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-04
Name of individual signing JAMES R GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE 401(K) PLAN 2018 201390452 2019-10-04 CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 7635888426
Plan sponsor’s address 3925 37TH AVENUE NORTH, ROBBINSDALE, MN, 55422

Signature of
Role Plan administrator
Date 2019-10-02
Name of individual signing JAMES GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-02
Name of individual signing JAMES GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE 401(K) PLAN 2017 201390452 2018-09-26 CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 7635888426
Plan sponsor’s address 3925 37TH AVENUE NORTH, ROBBINSDALE, MN, 55422

Signature of
Role Plan administrator
Date 2018-09-26
Name of individual signing JAMES R GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-26
Name of individual signing JAMES R GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE 401(K) PLAN 2016 201390452 2017-08-07 CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 7635888426
Plan sponsor’s address 3925 37TH AVENUE NORTH, ROBBINSDALE, MN, 55422

Signature of
Role Plan administrator
Date 2017-08-03
Name of individual signing JAMES GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-03
Name of individual signing JAMES GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE 401(K) PLAN 2015 201390452 2016-09-09 CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 7635888426
Plan sponsor’s address 3925 37TH AVENUE NORTH, ROBBINSDALE, MN, 55422

Signature of
Role Plan administrator
Date 2016-09-09
Name of individual signing JAMES R GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-09
Name of individual signing JAMES R GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE 401(K) PLAN 2014 201390452 2015-09-14 CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 7635888426
Plan sponsor’s address 3925 37TH AVENUE NORTH, ROBBINSDALE, MN, 55422

Signature of
Role Plan administrator
Date 2015-09-13
Name of individual signing JAMES R. GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-13
Name of individual signing JAMES R. GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE 401(K) PLAN 2013 201390452 2014-07-24 CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 7635888426
Plan sponsor’s address 3925 37TH AVENUE NORTH, ROBBINSDALE, MN, 55422

Signature of
Role Plan administrator
Date 2014-07-24
Name of individual signing JAMES R. GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-24
Name of individual signing JAMES R. GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE 401(K) PLAN 2012 201390452 2013-10-09 CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 7635888426
Plan sponsor’s address 3925 37TH AVENUE NORTH, ROBBINSDALE, MN, 55422

Signature of
Role Plan administrator
Date 2013-10-09
Name of individual signing JAMES GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-09
Name of individual signing JAMES GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE 401(K) PLAN 2011 201390452 2012-10-04 CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 7635888426
Plan sponsor’s address 3925 37TH AVENUE NORTH, ROBBINSDALE, MN, 55422

Plan administrator’s name and address
Administrator’s EIN 201390452
Plan administrator’s name CRYSTAL LAKE DENTAL CARE OF ROBBINSDALE PLLC
Plan administrator’s address 3925 37TH AVENUE NORTH, ROBBINSDALE, MN, 55422
Administrator’s telephone number 7635888426

Signature of
Role Plan administrator
Date 2012-10-04
Name of individual signing JAMES GAASEDELEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-04
Name of individual signing JAMES GAASEDELEN
Valid signature Filed with authorized/valid electronic signature

Manager

Name Role Address
James Gaasedelen Manager 3925 37th Avenue North, Robbinsdale, MN 55422, USA

Filing

Filing Name Filing date
Administrative Termination - Limited Liability Company (Domestic) 2023-01-30
Conversion to 322C Due to Statute Mandate – Limited Liability Company (Domestic) 2018-01-01
Original Filing - Limited Liability Company (Domestic) 2004-10-14
Limited Liability Company (Domestic) Business Name (Business Name: Crystal Lake Dental Care of Robbinsdale PLLC) 2004-10-14

Related by officers

No related officers

Related by address

3925 37th Ave N, Robbinsdale, MN 55422, USA

Hills & Berg Crystal Lake Dental Care

Date of last update: 30 Nov 2024

Sources: Minnesota's Official State Website

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