| Plan Name | PINE RIDGE DENTAL 401(K) PROFIT SHARING PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | PINE RIDGE DENTAL, P.A. |
| Employer identification number (EIN): | 412001754 |
| 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 | 2013-01-01 | JENNIFER NARR | 2013-05-29 | ||
| 001 | 2012-01-01 | JENNIFER NARR | 2013-05-29 | ||
| 001 | 2011-01-01 | BUDDY HORNER | 2012-09-24 |