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| Plan Name | KY DENTAL HLTH SPECIALISTS CBS BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | KENTUCKIANA DENTAL HEALTH SPECIALISTS, LLC |
| Employer identification number (EIN): | 825405191 |
| 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 | 2022-06-01 | SHAWNA BURTON | 2023-12-27 | ||
| 501 | 2021-07-01 | SHAWNA BURTON | 2022-12-29 |
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