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  5. POTACH & MITCHELL DENTAL CLINIC, P.A.

POTACH & MITCHELL DENTAL CLINIC, P.A.

Company Details

Name: POTACH & MITCHELL DENTAL CLINIC, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 27 Sep 1976 (48 years ago)
Company Number: c438a7cf-99d4-e011-a886-001ec94ffe7f
File Number: 2V-931
Registered Office Address: 607 1st Dr NW PO Bx 1064, Austin, MN 55912, USA
Principal Executive Office Address: 607 1st Drv NW, PO Box 1064, Austin, MN 55912, USA
ZIP code: 55912
County: Mower County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
POTACH & MITCHELL DENTAL CLINIC, P.A 401(K) PROFIT SHARING PLAN & TRUST 2023 411280716 2024-07-19 POTACH & MITCHELL DENTAL CLINIC, P.A. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1978-03-01
Business code 621210
Sponsor’s telephone number 5074376312
Plan sponsor’s address 607 1ST DRIVE NORTHWEST, AUSTIN, MN, 55912
POTACH & MITCHELL DENTAL CLINIC, P.A 401(K) PROFIT SHARING PLAN & TRUST 2022 411280716 2023-10-03 POTACH & MITCHELL DENTAL CLINIC, P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1978-03-01
Business code 621210
Sponsor’s telephone number 5074376312
Plan sponsor’s address 607 1ST DRIVE NORTHWEST, AUSTIN, MN, 55912
POTACH & MITCHELL DENTAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2020 411280716 2021-07-22 POTACH & MITCHELL DENTAL CLINIC, P.A. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1978-03-01
Business code 621210
Sponsor’s telephone number 5074376312
Plan sponsor’s address 607 FIRST DRIVE NW, AUSTIN, MN, 55912

Signature of
Role Plan administrator
Date 2021-07-22
Name of individual signing KURT S. POTACH
Valid signature Filed with authorized/valid electronic signature
POTACH & MITCHELL DENTAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2019 411280716 2020-07-13 POTACH & MITCHELL DENTAL CLINIC, P.A. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1978-03-01
Business code 621210
Sponsor’s telephone number 5074376312
Plan sponsor’s address 607 FIRST DRIVE NW, AUSTIN, MN, 55912

Signature of
Role Plan administrator
Date 2020-07-13
Name of individual signing KURT S. POTACH
Valid signature Filed with authorized/valid electronic signature
POTACH & MITCHELL DENTAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2018 411280716 2019-05-27 POTACH & MITCHELL DENTAL CLINIC, P.A. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1978-03-01
Business code 621210
Sponsor’s telephone number 5074376312
Plan sponsor’s address 607 FIRST DRIVE NW, AUSTIN, MN, 55912

Signature of
Role Plan administrator
Date 2019-05-27
Name of individual signing KURT S. POTACH
Valid signature Filed with authorized/valid electronic signature
POTACH & MITCHELL DENTAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2017 411280716 2018-05-29 POTACH & MITCHELL DENTAL CLINIC, P.A. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1978-03-01
Business code 621210
Sponsor’s telephone number 5074376312
Plan sponsor’s address 607 FIRST DRIVE NW, AUSTIN, MN, 55912

Signature of
Role Plan administrator
Date 2018-05-29
Name of individual signing KURT S. POTACH
Valid signature Filed with authorized/valid electronic signature
POTACH & MITCHELL DENTAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2016 411280716 2017-07-09 POTACH & MITCHELL DENTAL CLINIC, P.A. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1978-03-01
Business code 621210
Sponsor’s telephone number 5074376312
Plan sponsor’s address 607 FIRST DRIVE NW, AUSTIN, MN, 55912

Signature of
Role Plan administrator
Date 2017-07-09
Name of individual signing KURT S. POTACH
Valid signature Filed with authorized/valid electronic signature
POTACH & MITCHELL DENTAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2015 411280716 2016-05-04 POTACH & MITCHELL DENTAL CLINIC, P.A. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1978-03-01
Business code 621210
Sponsor’s telephone number 5074376312
Plan sponsor’s address 607 FIRST DRIVE NW, AUSTIN, MN, 55912

Signature of
Role Plan administrator
Date 2016-05-04
Name of individual signing KURT S. POTACH
Valid signature Filed with authorized/valid electronic signature
POTACH & MITCHELL DENTAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2014 411280716 2015-05-03 POTACH & MITCHELL DENTAL CLINIC, P.A. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1978-03-01
Business code 621210
Sponsor’s telephone number 5074376312
Plan sponsor’s address 607 FIRST DRIVE NW, AUSTIN, MN, 55912

Signature of
Role Plan administrator
Date 2015-05-03
Name of individual signing KURT S. POTACH
Valid signature Filed with authorized/valid electronic signature
POTACH & MITCHELL DENTAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2013 411280716 2014-06-17 POTACH & MITCHELL DENTAL CLINIC, P.A. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1978-03-01
Business code 621210
Sponsor’s telephone number 5074376312
Plan sponsor’s address 607 FIRST DRIVE NW, AUSTIN, MN, 55912

Plan administrator’s name and address
Administrator’s EIN 411280716
Plan administrator’s name POTACH & MITCHELL DENTAL CLINIC, P.A.
Plan administrator’s address 607 FIRST DRIVE NW, AUSTIN, MN, 55912
Administrator’s telephone number 5074376312

Signature of
Role Plan administrator
Date 2014-06-17
Name of individual signing KURT S. POTACH
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Kurt S Potach Chief Executive Officer 607 1st Drv NW, Austin, MN 55912, USA

Filing

Filing Name Filing date
Business Corporation (Domestic) Business Name (Business Name: POTACH & MITCHELL DENTAL CLINIC, P.A.) 2005-11-03
Business Corporation (Domestic) Business Name (Business Name: HERRICK & POTACH DENTAL CLINIC, P.A.) 1984-10-25
Business Corporation (Domestic) Active Status Report 1980-09-23
Registered Office and/or Agent - Business Corporation (Domestic) 1980-09-02
Original Filing - Business Corporation (Domestic) 1976-09-27
Business Corporation (Domestic) Business Name (Business Name: J. V. Herrick D.D.S., P.A.) 1976-09-27

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Date of last update: 02 Oct 2024

Sources: Minnesota's Official State Website

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