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| Plan Name | JAMES ELLIS DDS, INC. SOCA BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ELLIS ORAL SURGERY |
| Employer identification number (EIN): | 454068485 |
| NAIC Classification: | 621399 |
| NAIC Description: | Offices of All Other Miscellaneous Health Practitioners |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-05-01 | MATT APPENZELLER | 2022-11-29 | ||
| 501 | 2020-05-01 | MATT APPENZELLER | 2021-11-23 | ||
| 501 | 2019-05-01 | MATT APPENZELLER | 2020-11-06 | ||
| 501 | 2019-02-01 | MATT APPENZELLER | 2019-11-13 |