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  5. Dr. Eric Nordstrom DDS

Dr. Eric Nordstrom DDS

Company Details

Name: Dr. Eric Nordstrom DDS
Jurisdiction: Minnesota
Legal type: Assumed Name
Status: Inactive
Date formed: 29 Nov 2016 (8 years ago)
Company Number: ed0778e7-4ab6-e611-8167-00155d46d26e
File Number: 917421300020
Principal Place of Business Address: 309 Lakeland Dr. S.E., Suite #1, Willmar, MN 56201, USA
ZIP code: 56201
County: Kandiyohi County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DR. ERIC NORDSTROM, DDS SAFE HARBOR 401 K PLAN 2016 411844337 2017-04-27 DR. ERIC NORDSTROM, DDS 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621210
Sponsor’s telephone number 3202351075
Plan sponsor’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201

Signature of
Role Plan administrator
Date 2017-04-27
Name of individual signing DR. ERIC NORDSTROM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-04-27
Name of individual signing BETH NORDSTROM
Valid signature Filed with authorized/valid electronic signature
DR. ERIC NORDSTROM, DDS SAFE HARBOR 401 K PLAN 2015 411844337 2016-10-11 DR. ERIC NORDSTROM, DDS 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621210
Sponsor’s telephone number 3202351075
Plan sponsor’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201

Signature of
Role Plan administrator
Date 2016-10-11
Name of individual signing DR. ERIC NORDSTROM
Valid signature Filed with authorized/valid electronic signature
DR. ERIC NORDSTROM, DDS SAFE HARBOR 401(K) 2014 411844337 2015-05-18 DR. ERIC NORDSTROM, DDS 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621210
Sponsor’s telephone number 6127204040
Plan sponsor’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201

Signature of
Role Plan administrator
Date 2015-05-18
Name of individual signing DR. ERIC NORDSTROM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-05-18
Name of individual signing DR. ERIC NORDSTROM
Valid signature Filed with authorized/valid electronic signature
DR. ERIC NORDSTROM, DDS SAFE HARBOR 401(K) 2013 411844337 2014-06-02 DR. ERIC NORDSTROM, DDS 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621210
Sponsor’s telephone number 6127204040
Plan sponsor’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201

Signature of
Role Plan administrator
Date 2014-06-02
Name of individual signing BETH NORDSTROM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-06-02
Name of individual signing BETH NORDSTROM
Valid signature Filed with authorized/valid electronic signature
DR. ERIC NORDSTROM, DDS SAFE HARBOR 401K PLAN 2012 411844337 2013-06-26 DR. ERIC NORDSTROM, DDS 4
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621210
Sponsor’s telephone number 3202351075
Plan sponsor’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201

Signature of
Role Plan administrator
Date 2013-06-26
Name of individual signing DR. ERIC NORDSTROM, DDS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-26
Name of individual signing DR. ERIC NORDSTROM, DDS
Valid signature Filed with authorized/valid electronic signature
DR. ERIC NORDSTROM, DDS SAFE HARBOR 401K PLAN 2012 411844337 2013-06-26 DR. ERIC NORDSTROM, DDS 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621210
Sponsor’s telephone number 3202351075
Plan sponsor’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201

Signature of
Role Plan administrator
Date 2013-06-26
Name of individual signing DR. ERIC NORDSTROM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-26
Name of individual signing DR. ERIC NORDSTROM
Valid signature Filed with authorized/valid electronic signature
DR. ERIC NORDSTROM, DDS SAFE HARBOR 401K PLAN 2011 411844337 2012-06-27 DR. ERIC NORDSTROM, DDS 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621210
Sponsor’s telephone number 3202351075
Plan sponsor’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201

Plan administrator’s name and address
Administrator’s EIN 411844337
Plan administrator’s name DR. ERIC NORDSTROM, DDS
Plan administrator’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201
Administrator’s telephone number 3202351075

Signature of
Role Plan administrator
Date 2012-06-27
Name of individual signing DR. ERIC NORDSTROM, DDS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-06-27
Name of individual signing DR. ERIC NORDSTROM, DDS
Valid signature Filed with authorized/valid electronic signature
DR. ERIC NORDSTROM, DDS SAFE HARBOR 401K PLAN 2010 411844337 2011-07-28 DR. ERIC NORDSTROM, DDS 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621210
Sponsor’s telephone number 3202351075
Plan sponsor’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201

Plan administrator’s name and address
Administrator’s EIN 411844337
Plan administrator’s name DR. ERIC NORDSTROM, DDS
Plan administrator’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201
Administrator’s telephone number 3202351075

Signature of
Role Plan administrator
Date 2011-07-28
Name of individual signing DR. ERIC NORDSTROM, DDS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-28
Name of individual signing DR. ERIC NORDSTROM, DDS
Valid signature Filed with authorized/valid electronic signature
DR. ERIC NORDSTROM, DDS SAFE HARBOR 401K PLAN 2009 411844337 2010-09-14 DR. ERIC NORDSTROM, DDS 5
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621210
Sponsor’s telephone number 3202351075
Plan sponsor’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201

Plan administrator’s name and address
Administrator’s EIN 411844337
Plan administrator’s name DR. ERIC NORDSTROM, DDS
Plan administrator’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201
Administrator’s telephone number 3202351075

Signature of
Role Plan administrator
Date 2010-09-14
Name of individual signing DR. ERIC NORDSTROM, DDS
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-09-14
Name of individual signing DR. ERIC NORDSTROM, DDS
Valid signature Filed with incorrect/unrecognized electronic signature
DR. ERIC NORDSTROM, DDS SAFE HARBOR 401K PLAN 2009 411844337 2010-09-14 DR. ERIC NORDSTROM, DDS 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-06-01
Business code 621210
Sponsor’s telephone number 3202351075
Plan sponsor’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201

Plan administrator’s name and address
Administrator’s EIN 411844337
Plan administrator’s name DR. ERIC NORDSTROM, DDS
Plan administrator’s address 309 LAKELAND DRIVE SE, SUITE 1, WILLMAR, MN, 56201
Administrator’s telephone number 3202351075

Signature of
Role Plan administrator
Date 2010-09-14
Name of individual signing DR. ERIC NORDSTROM, DDS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-14
Name of individual signing DR. ERIC NORDSTROM, DDS
Valid signature Filed with authorized/valid electronic signature

Aplicant

Name Role Address
Willmar Dental Consultants, PLLC Aplicant 309 Lakeland Drv SE #1, Willmar, MN 56201
Willmar Dental Consultants Aplicant 309 Lakeland Drv SE #1, Willmar, MN 56201
Eric Dale Nordstrom Aplicant 638 135th Str NE, Atwater, MN 56209

Filing

Filing Name Filing date
Administrative Expiration - Assumed Name 2019-03-11
Amendment - Assumed Name 2017-08-15
Original Filing - Assumed Name (Business Name: Dr. Eric Nordstrom DDS) 2016-11-29

Related by officers

Eric Dale Nordstrom

Ascaland Properties, LLC Willmar Dental Consultants PLLC

Related by address

No related companies by address

Date of last update: 24 Sep 2024

Sources: Minnesota's Official State Website

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