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  5. Autumn Ridge Dental Partnership

Autumn Ridge Dental Partnership

Company Details

Name: Autumn Ridge Dental Partnership
Jurisdiction: MISSISSIPPI
Business Type: General Partnership
Status: Good Standing
Effective Date: 17 Jul 2014 (11 years ago)
Business ID: 1045022
ZIP code: 39090
County: Attala
State of Incorporation: MISSISSIPPI
Principal Office Address: 101 Ridgewood Cir.Kosciusko, MS 39090

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AUTUMN RIDGE DENTAL RETIREMENT PLAN & TRUST 2023 273932076 2024-06-20 AUTUMN RIDGE DENTAL PARTNERSHIP 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 6622897076
Plan sponsor’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090
AUTUMN RIDGE DENTAL RETIREMENT PLAN & TRUST 2022 273932076 2023-08-30 AUTUMN RIDGE DENTAL PARTNERSHIP 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 6622897076
Plan sponsor’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090
AUTUMN RIDGE DENTAL RETIREMENT PLAN & TRUST 2021 273932076 2022-07-20 AUTUMN RIDGE DENTAL PARTNERSHIP 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 6622897076
Plan sponsor’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090
AUTUMN RIDGE DENTAL RETIREMENT PLAN & TRUST 2020 273932076 2021-06-10 AUTUMN RIDGE DENTAL PARTNERSHIP 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 6622897076
Plan sponsor’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090

Signature of
Role Plan administrator
Date 2021-06-10
Name of individual signing P. ADAM MIDDLETON, D.M.D.
Valid signature Filed with authorized/valid electronic signature
AUTUMN RIDGE DENTAL RETIREMENT PLAN & TRUST 2019 273932076 2020-07-16 AUTUMN RIDGE DENTAL PARTNERSHIP 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 6622897076
Plan sponsor’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090

Signature of
Role Plan administrator
Date 2020-07-16
Name of individual signing P. ADAM MIDDLETON, D.M.D.
Valid signature Filed with authorized/valid electronic signature
AUTUMN RIDGE DENTAL RETIREMENT PLAN & TRUST 2018 273932076 2019-08-26 AUTUMN RIDGE DENTAL PARTNERSHIP 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 6622897076
Plan sponsor’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090

Signature of
Role Plan administrator
Date 2019-08-26
Name of individual signing P. ADAM MIDDLETON, D.M.D.
Valid signature Filed with authorized/valid electronic signature
AUTUMN RIDGE DENTAL RETIREMENT PLAN & TRUST 2017 273932076 2018-09-13 AUTUMN RIDGE DENTAL PARTNERSHIP 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 6622897076
Plan sponsor’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090

Signature of
Role Plan administrator
Date 2018-09-13
Name of individual signing P. ADAM MIDDLETON, D.M.D.
Valid signature Filed with authorized/valid electronic signature
AUTUMN RIDGE DENTAL RETIREMENT PLAN & TRUST 2016 273932076 2017-09-04 AUTUMN RIDGE DENTAL PARTNERSHIP 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 6622897076
Plan sponsor’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090

Signature of
Role Plan administrator
Date 2017-09-04
Name of individual signing P. ADAM MIDDLETON, D.M.D.
Valid signature Filed with authorized/valid electronic signature
AUTUMN RIDGE DENTAL RETIREMENT PLAN & TRUST 2015 273932076 2016-06-01 AUTUMN RIDGE DENTAL PARTNERSHIP 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 6622897076
Plan sponsor’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090

Signature of
Role Plan administrator
Date 2016-06-01
Name of individual signing P. ADAM MIDDLETON, D.M.D.
Valid signature Filed with authorized/valid electronic signature
AUTUMN RIDGE DENTAL RETIREMENT PLAN & TRUST 2014 273932076 2015-10-07 AUTUMN RIDGE DENTAL PARTNERSHIP 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 6622897076
Plan sponsor’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090

Signature of
Role Plan administrator
Date 2015-10-07
Name of individual signing P. ADAM MIDDLETON, D.M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/13/20141013100919P040017978751001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 6622897076
Plan sponsor’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090

Signature of
Role Plan administrator
Date 2014-10-13
Name of individual signing P. ADAM MIDDLETON, D.M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/09/30/20130930174330P030006386789001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 6622897076
Plan sponsor’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090

Plan administrator’s name and address
Administrator’s EIN 273932076
Plan administrator’s name AUTUMN RIDGE DENTAL PARTNERSHIP
Plan administrator’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090
Administrator’s telephone number 6622897076

Signature of
Role Plan administrator
Date 2013-09-30
Name of individual signing DONALD Q. WEAVER, D.M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/09/19/20120919161848P040005153988001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 6622897076
Plan sponsor’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090

Plan administrator’s name and address
Administrator’s EIN 273932076
Plan administrator’s name AUTUMN RIDGE DENTAL PARTNERSHIP
Plan administrator’s address 101 RIDGEWOOD CIRCLE, KOSCIUSKO, MS, 39090
Administrator’s telephone number 6622897076

Signature of
Role Plan administrator
Date 2012-09-19
Name of individual signing DONALD Q. WEAVER, D.M.D.
Valid signature Filed with authorized/valid electronic signature

Partner

Name Role Address
Philip A. Middleton, P.A. Partner 101 Ridgewood Cir., Kosciusko, MS 39090
Paul Devon Gundy PA Partner 101 Ridgewood Cir., Kosciusko, MS 39090

Filings

Type Status Filed Date Description
Formation Form Filed 2014-07-17 Formation

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 11 Jan 2025

Sources: Mississippi Secretary of State

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