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  5. Penn Avenue Family Dental, Inc.

Penn Avenue Family Dental, Inc.

Company Details

Name: Penn Avenue Family Dental, Inc.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Inactive
Date formed: 28 Dec 2005 (19 years ago)
Company Number: b4945acc-8cd4-e011-a886-001ec94ffe7f
File Number: 1646192-2
Registered Office Address: 5346 Penn Ave S, Mpls, MN 55419, USA
Principal Executive Office Address: 5346 Penn Avenue South, Minneapolis, MN 55419, USA
ZIP code: 55419
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PENN AVENUE FAMILY DENTAL 401K PLAN 2019 161744613 2020-11-02 PENN AVENUE FAMILY DENTAL, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-08-01
Business code 621210
Sponsor’s telephone number 6129220894
Plan sponsor’s address 5346 PENN AVENUE S, MINNEAPOLIS, MN, 55419

Signature of
Role Plan administrator
Date 2020-11-02
Name of individual signing ROBERT MCNAB
Valid signature Filed with authorized/valid electronic signature
PENN AVENUE FAMILY DENTAL 401K PLAN 2019 161744613 2020-10-27 PENN AVENUE FAMILY DENTAL, INC. 12
Three-digit plan number (PN) 001
Effective date of plan 2006-08-01
Business code 621210
Sponsor’s telephone number 6129220894
Plan sponsor’s address 5346 PENN AVENUE S, MINNEAPOLIS, MN, 55419

Signature of
Role Plan administrator
Date 2020-10-27
Name of individual signing ROBERT MCNAB
Valid signature Filed with authorized/valid electronic signature
PENN AVENUE FAMILY DENTAL 401K PLAN 2018 161744613 2019-07-18 PENN AVENUE FAMILY DENTAL, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-08-01
Business code 621210
Sponsor’s telephone number 6129220894
Plan sponsor’s address 5346 PENN AVENUE S, MINNEAPOLIS, MN, 55419

Signature of
Role Plan administrator
Date 2019-07-18
Name of individual signing TONI YOUNGMAN
Valid signature Filed with authorized/valid electronic signature
PENN AVENUE FAMILY DENTAL 401K PLAN 2017 161744613 2018-06-11 PENN AVENUE FAMILY DENTAL, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-08-01
Business code 621210
Sponsor’s telephone number 6129220894
Plan sponsor’s address 5346 PENN AVENUE S, MINNEAPOLIS, MN, 55419

Signature of
Role Plan administrator
Date 2018-06-11
Name of individual signing TONI YOUNGMAN
Valid signature Filed with authorized/valid electronic signature
PENN AVENUE FAMILY DENTAL 401K PLAN 2016 161744613 2017-05-17 PENN AVENUE FAMILY DENTAL, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-08-01
Business code 621210
Sponsor’s telephone number 6129220894
Plan sponsor’s address 5346 PENN AVENUE S, MINNEAPOLIS, MN, 55419

Signature of
Role Plan administrator
Date 2017-05-17
Name of individual signing TONI YOUNGMAN
Valid signature Filed with authorized/valid electronic signature
PENN AVENUE FAMILY DENTAL 401K PLAN 2015 161744613 2016-05-24 PENN AVENUE FAMILY DENTAL, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-08-01
Business code 621210
Sponsor’s telephone number 6129220894
Plan sponsor’s address 5346 PENN AVENUE S, MINNEAPOLIS, MN, 55419

Signature of
Role Plan administrator
Date 2016-05-24
Name of individual signing ROBERT MCNAB
Valid signature Filed with authorized/valid electronic signature
PENN AVENUE FAMILY DENTAL 401K PLAN 2014 161744613 2015-06-04 PENN AVENUE FAMILY DENTAL, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-08-01
Business code 621210
Sponsor’s telephone number 6129220894
Plan sponsor’s address 5346 PENN AVENUE S, MINNEAPOLIS, MN, 55419

Signature of
Role Plan administrator
Date 2015-06-04
Name of individual signing ROBERT MCNAB
Valid signature Filed with authorized/valid electronic signature
PENN AVENUE FAMILY DENTAL 401K PLAN 2013 161744613 2014-06-30 PENN AVENUE FAMILY DENTAL, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-08-01
Business code 621210
Sponsor’s telephone number 6129220894
Plan sponsor’s address 5346 PENN AVENUE S, MINNEAPOLIS, MN, 55419

Signature of
Role Plan administrator
Date 2014-06-30
Name of individual signing ROBERT MCNAB
Valid signature Filed with authorized/valid electronic signature
PENN AVENUE FAMILY DENTAL 401K PLAN 2012 161744613 2013-07-01 PENN AVENUE FAMILY DENTAL, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-08-01
Business code 621210
Sponsor’s telephone number 6129220894
Plan sponsor’s address 5346 PENN AVENUE S, MINNEAPOLIS, MN, 55419

Signature of
Role Plan administrator
Date 2013-07-01
Name of individual signing TONI YOUNGMAN
Valid signature Filed with authorized/valid electronic signature
PENN AVENUE FAMILY DENTAL 401K PLAN 2011 161744613 2012-07-17 PENN AVENUE FAMILY DENTAL, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-08-01
Business code 621210
Sponsor’s telephone number 6129220894
Plan sponsor’s address 5346 PENN AVENUE S, MINNEAPOLIS, MN, 55419

Plan administrator’s name and address
Administrator’s EIN 161744613
Plan administrator’s name PENN AVENUE FAMILY DENTAL, INC.
Plan administrator’s address 5346 PENN AVENUE S, MINNEAPOLIS, MN, 55419
Administrator’s telephone number 6129220894

Signature of
Role Plan administrator
Date 2012-07-17
Name of individual signing TONI YOUNGMAN
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Robert George McNab Chief Executive Officer 5346 Penn Avenue South, Minneapolis, MN 55419, USA

Filing

Filing Name Filing date
Annual Reinstatement - Business Corporation (Domestic) 2018-12-27
Administrative Dissolution - Business Corporation (Domestic) 2008-01-09
Original Filing - Business Corporation (Domestic)Professional Service - Dentistry & Dental Hygiene 2005-12-28
Business Corporation (Domestic) Business Name (Business Name: Penn Avenue Family Dental, Inc.) 2005-12-28

Related by officers

No related officers

Related by address

5346 Penn Avenue South, Minneapolis, MN 55419, USA

PAFD LLC Penn Avenue Family Dental, Inc PROFESSIONAL CORPORATION

Date of last update: 03 Oct 2024

Sources: Minnesota's Official State Website

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