| Plan Name | TREASURE VALLEY PEDIATRIC DENTISTRY WELFARE BENEFIT PLAN NATIONAL BENEFIT TRUST I |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | TREASURE VALLEY PEDIATRIC DENTISTRY |
| Employer identification number (EIN): | 200149412 |
| NAIC Classification: | 621210 |
| NAIC Description: | Offices of Dentists |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2010-01-01 | ROY H. ROGERS | 2010-12-08 |