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  5. Great River Dental, P.A.

Great River Dental, P.A.

Company Details

Name: Great River Dental, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 14 Feb 2002 (23 years ago)
Company Number: caef094c-abd4-e011-a886-001ec94ffe7f
File Number: 12A-193
Registered Office Address: 375 Jackson Str #200, St Paul, MN 55101, USA
Principal Executive Office Address: STE 200, 375 JACKSON ST, SAINT PAUL, MN 55101–1806, USA
ZIP code: 55101
County: Ramsey County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GREAT RIVER DENTAL, P.A. 401(K) PROFIT SHARING PLAN 2023 020540071 2024-10-14 GREAT RIVER DENTAL, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6512220983
Plan sponsor’s address 375 JACKSON ST #200, SAINT PAUL, MN, 551011806

Signature of
Role Plan administrator
Date 2024-10-14
Name of individual signing HEIDI BENSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-14
Name of individual signing HEIDI BENSON
Valid signature Filed with authorized/valid electronic signature
GREAT RIVER DENTAL, P.A. 401(K) PROFIT SHARING PLAN 2022 020540071 2023-10-13 GREAT RIVER DENTAL, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6512220983
Plan sponsor’s address 375 JACKSON ST #200, SAINT PAUL, MN, 551011806

Signature of
Role Plan administrator
Date 2023-10-13
Name of individual signing JEFFREY ROZINKA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-13
Name of individual signing JEFFREY ROZINKA
Valid signature Filed with authorized/valid electronic signature
GREAT RIVER DENTAL, P.A. 401(K) PROFIT SHARING PLAN 2021 020540071 2022-02-17 GREAT RIVER DENTAL, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6512220983
Plan sponsor’s address 375 JACKSON ST #200, SAINT PAUL, MN, 551011806

Signature of
Role Plan administrator
Date 2022-02-17
Name of individual signing BENJAMEN HAMANN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-02-17
Name of individual signing BENJAMEN HAMANN
Valid signature Filed with authorized/valid electronic signature
GREAT RIVER DENTAL, P.A. 401(K) PROFIT SHARING PLAN 2020 020540071 2021-10-13 GREAT RIVER DENTAL, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6512220983
Plan sponsor’s address 375 JACKSON ST #200, SAINT PAUL, MN, 551011806

Signature of
Role Plan administrator
Date 2021-10-13
Name of individual signing BENJAMEN HAMANN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-13
Name of individual signing BENJAMEN HAMANN
Valid signature Filed with authorized/valid electronic signature
GREAT RIVER DENTAL, P.A. 401(K) PROFIT SHARING PLAN 2019 020540071 2020-07-23 GREAT RIVER DENTAL, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6512220983
Plan sponsor’s address 375 JACKSON ST #200, SAINT PAUL, MN, 551011806

Signature of
Role Plan administrator
Date 2020-07-23
Name of individual signing LAURA FUNKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-23
Name of individual signing LAURA FUNKE
Valid signature Filed with authorized/valid electronic signature
GREAT RIVER DENTAL, P.A. 401(K) PROFIT SHARING PLAN 2018 020540071 2019-07-08 GREAT RIVER DENTAL, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6512220983
Plan sponsor’s address 375 JACKSON ST #200, SAINT PAUL, MN, 551011806

Signature of
Role Plan administrator
Date 2019-07-08
Name of individual signing JEFFREY ROZINKA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-08
Name of individual signing JEFFREY ROZINKA
Valid signature Filed with authorized/valid electronic signature
GREAT RIVER DENTAL, P.A. 401(K) PROFIT SHARING PLAN 2017 020540071 2018-02-28 GREAT RIVER DENTAL, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6512220983
Plan sponsor’s address 375 JACKSON ST #200, SAINT PAUL, MN, 551011806

Signature of
Role Plan administrator
Date 2018-02-28
Name of individual signing JEFFREY ROZINKA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-02-28
Name of individual signing JEFFREY ROZINKA
Valid signature Filed with authorized/valid electronic signature
GREAT RIVER DENTAL, P.A. 401(K) PROFIT SHARING PLAN 2016 020540071 2017-02-20 GREAT RIVER DENTAL, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6512220983
Plan sponsor’s address 375 JACKSON ST #200, SAINT PAUL, MN, 551011806

Signature of
Role Plan administrator
Date 2017-02-20
Name of individual signing JEFFREY ROZINKA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-02-20
Name of individual signing JEFFREY ROZINKA
Valid signature Filed with authorized/valid electronic signature
GREAT RIVER DENTAL, P.A. 401(K) PROFIT SHARING PLAN 2015 020540071 2016-04-07 GREAT RIVER DENTAL, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6512220983
Plan sponsor’s address 375 JACKSON ST #200, SAINT PAUL, MN, 551011806

Signature of
Role Plan administrator
Date 2016-04-07
Name of individual signing JEFFREY ROZINKA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-04-07
Name of individual signing JEFFREY ROZINKA
Valid signature Filed with authorized/valid electronic signature
GREAT RIVER DENTAL, P.A. 401(K) PROFIT SHARING PLAN 2014 020540071 2015-05-11 GREAT RIVER DENTAL, P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6512220983
Plan sponsor’s address 375 JACKSON ST #200, SAINT PAUL, MN, 551011806

Signature of
Role Plan administrator
Date 2015-05-11
Name of individual signing JEFFREY ROZINKA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-05-11
Name of individual signing JEFFREY ROZINKA
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Jeffrey Rozinka Chief Executive Officer STE 200, 375 JACKSON ST, SAINT PAUL, MN 55101–1806, USA

Filing

Filing Name Filing date
Annual Reinstatement - Business Corporation (Domestic) 2021-10-07
Administrative Dissolution - Business Corporation (Domestic) 2021-02-11
Registered Office and/or Agent - Business Corporation (Domestic) 2002-12-04
Original Filing - Business Corporation (Domestic) 2002-02-14
Business Corporation (Domestic) Business Name (Business Name: Great River Dental, P.A.) 2002-02-14
Original Filing - Business Corporation (Domestic)Professional Service - Dentistry & Dental Hygiene 2002-02-14

Related by officers

No related officers

Related by address

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Date of last update: 13 Jan 2025

Sources: Minnesota's Official State Website

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