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Gustafson Family Dentistry, P.A.

Gustafson Family Dentistry, P.A.

Company Details

Name:	Gustafson Family Dentistry, P.A.
Jurisdiction:	Minnesota
Legal type:	Business Corporation (Domestic)
Status:	Active / In Good Standing
Date formed:	17 Dec 1981 (43 years ago)
Company Number:	94461032-a9d4-e011-a886-001ec94ffe7f
File Number:	4A-480
Registered Office Address:	106 3rd Ave NW, Arlington, MN 55307, USA
Principal Executive Office Address:	106 3RD AVE NW, ARLINGTON, MN 55307, USA
ZIP code:	55307
County:	Sibley County
Place of Formation:	Minnesota

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

GUSTAFSON FAMILY DENTISTRY 401(K) PLAN

2022

411426875

2024-02-22

GUSTAFSON FAMILY DENTISTRY, P.A.

9

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-12-01
Business code	621210
Sponsor’s telephone number	5079645982
Plan sponsor’s address	106 3RD AVE STE 312, P.O. BOX 352, ARLINGTON, MN, 55307

GUSTAFSON FAMILY DENTISTRY 401(K) PLAN

2021

411426875

2023-02-02

GUSTAFSON FAMILY DENTISTRY, P.A.

9

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-12-01
Business code	621210
Sponsor’s telephone number	5079645982
Plan sponsor’s address	106 3RD AVE STE 312, P.O. BOX 352, ARLINGTON, MN, 55307

GUSTAFSON FAMILY DENTISTRY 401(K) PLAN

2020

411426875

2022-08-22

GUSTAFSON FAMILY DENTISTRY, P.A.

9

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-12-01
Business code	621210
Sponsor’s telephone number	5079645982
Plan sponsor’s address	106 3RD AVE STE 312, P.O. BOX 352, ARLINGTON, MN, 55307

GUSTAFSON FAMILY DENTISTRY 401(K) PLAN

2019

411426875

2021-01-13

GUSTAFSON FAMILY DENTISTRY, P.A.

8

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-12-01
Business code	621210
Sponsor’s telephone number	5079645982
Plan sponsor’s address	106 3RD AVE STE 312, P.O. BOX 352, ARLINGTON, MN, 55307

GUSTAFSON FAMILY DENTISTRY 401(K) PLAN

2018

411426875

2020-01-10

GUSTAFSON FAMILY DENTISTRY, P.A.

8

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-12-01
Business code	621210
Sponsor’s telephone number	5079645982
Plan sponsor’s address	106 3RD AVE, P.O. BOX 352, ARLINGTON, MN, 55307

GUSTAFSON FAMILY DENTISTRY 401(K) PLAN

2017

411426875

2019-05-02

GUSTAFSON FAMILY DENTISTRY, P.A.

11

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-12-01
Business code	621210
Sponsor’s telephone number	5079642705
Plan sponsor’s address	106 3RD AVE, P.O. BOX 352, ARLINGTON, MN, 55307

GUSTAFSON FAMILY DENTISTRY 401(K) PLAN

2016

411426875

2018-04-25

GUSTAFSON FAMILY DENTISTRY, P.A.

10

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-12-01
Business code	621210
Sponsor’s telephone number	5079642705
Plan sponsor’s address	106 3RD AVE, ARLINGTON, MN, 55307

Chief Executive Officer

Name	Role	Address
Jared D Gustafson	Chief Executive Officer	106 3rd Ave NW, Arlington, MN 55307, USA

Agent

Name	Role
John D Gustafson	Agent

Filing

Filing Name	Filing date
Amendment - Business Corporation (Domestic) (Business Name: Gustafson Family Dentistry, P.A.)	2014-02-07
Original Filing - Business Corporation (Domestic) (Business Name: John D. Gustafson, D.D.S. P.A.)	1981-12-17

Date of last update: 01 Oct 2024

Sources: Minnesota's Official State Website