| Plan Name | COUNTRY CLUB DENTAL 401K PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | COUNTRY CLUB FAMILY DENTAL CARE LLC |
| Employer identification number (EIN): | 201438729 |
| 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 |
|---|---|---|---|---|---|
| 001 | 2022-01-01 | MICHAEL S. TORNOW | 2023-10-09 | ||
| 001 | 2021-01-01 | MICHAEL S. TORNOW | 2022-10-17 | ||
| 001 | 2020-01-01 | MICHAEL S. TORNOW | 2021-10-15 | ||
| 001 | 2019-01-01 | MICHAEL S. TORNOW | 2020-10-12 | ||
| 001 | 2018-01-01 | MICHAEL S. TORNOW | 2019-10-15 | ||
| 001 | 2011-01-01 | MICHAEL S. TORNOW | 2012-05-15 | ||
| 001 | 2010-01-01 | MICHAEL S. TORNOW | 2011-03-18 |