| Plan Name | CAPITOLA DENTAL LAB 401 K PROFIT SHARING PLAN & TRUST |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | CAPITOLA DENTAL LAB |
| Employer identification number (EIN): | 161769307 |
| NAIC Classification: | 621510 |
| NAIC Description: | Medical and Diagnostic Laboratories |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2010-01-01 | DIANA YBARRA | 2012-10-22 |