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| Company Name: | DELTA DENTAL OF OHIO |
| Employer identification number (EIN): | 210685339 |
| National Association of Insurance Commissioner's ID: | 54402 |
| NAIC Classification: | 54402 |
| AFFINITY SPECIALTY APPAREL, INC | AFFINITY APPAREL WELFARE BENEFITS PLAN | 2015-01-01 |
| THE BELLEVUE HOSPITAL | THE BELLEVUE HOSPITAL EMPLOYEE BENEFITS PLAN 503 | 2015-01-01 |
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