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Life Dental Group, LLC

Company Details

Name: Life Dental Group, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 26 May 2017 (8 years ago)
Business ID: 1119853
ZIP code: 38655
County: Lafayette
State of Incorporation: MISSISSIPPI
Principal Office Address: 306 Enterprise Dr, P O Box 1156Oxford, MS 38655

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LIFE DENTAL GROUP, LLC 401(K) PLAN 2023 821977654 2024-05-20 LIFE DENTAL GROUP, LLC 123
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 6622817220
Plan sponsor’s address 306 ENTERPRISE DR., OXFORD, MS, 38655

Signature of

Role Plan administrator
Date 2024-05-20
Name of individual signing CHARLES HARRIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-05-20
Name of individual signing CHARLES HARRIS
Valid signature Filed with authorized/valid electronic signature
LIFE DENTAL GROUP, LLC 401(K) PLAN 2022 821977654 2023-08-04 LIFE DENTAL GROUP, LLC 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 6622817220
Plan sponsor’s address 306 ENTERPRISE DR., OXFORD, MS, 38655

Signature of

Role Plan administrator
Date 2023-08-04
Name of individual signing CHARLES HARRIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-08-04
Name of individual signing CHARLES HARRIS
Valid signature Filed with authorized/valid electronic signature
LIFE DENTAL GROUP, LLC 401(K) PLAN 2021 821977654 2022-09-22 LIFE DENTAL GROUP, LLC 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 6622817220
Plan sponsor’s address 306 ENTERPRISE DR., OXFORD, MS, 38655

Signature of

Role Plan administrator
Date 2022-09-22
Name of individual signing WILLIAM BRYANT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-22
Name of individual signing WILLIAM BRYANT
Valid signature Filed with authorized/valid electronic signature
LIFE DENTAL GROUP, LLC 401(K) PLAN 2020 821977654 2021-08-11 LIFE DENTAL GROUP, LLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 6622817220
Plan sponsor’s address 306 ENTERPRISE DR., OXFORD, MS, 38655

Signature of

Role Plan administrator
Date 2021-08-10
Name of individual signing WILLIAM BRYANT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-08-10
Name of individual signing WILLIAM BRYANT
Valid signature Filed with authorized/valid electronic signature
LIFE DENTAL GROUP, LLC 401(K) PLAN 2019 821977654 2020-07-25 LIFE DENTAL GROUP, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 6622817220
Plan sponsor’s address 306 ENTERPRISE DR., OXFORD, MS, 38655

Signature of

Role Plan administrator
Date 2020-07-22
Name of individual signing DOUG BLAYLOCK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-22
Name of individual signing DOUG BLAYLOCK
Valid signature Filed with authorized/valid electronic signature
LIFE DENTAL GROUP, LLC 401(K) PLAN 2018 821977654 2019-09-16 LIFE DENTAL GROUP, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 6622817220
Plan sponsor’s address 306 ENTERPRISE DR., OXFORD, MS, 38655

Signature of

Role Plan administrator
Date 2019-09-13
Name of individual signing DOUG BLAYLOCK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-13
Name of individual signing DOUG BLAYLOCK
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
William Alias Agent 306 Enterprise Drive, Oxford, MS 38655

Organizer

Name Role Address
Bo Harwell Organizer 1020 Highland Colony Parkway, Suite 1400, Ridgeland, MS 39157

Member

Name Role Address
William Alias Member PO Box 1156, Oxford, MS 38655

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2024-03-06 Annual Report For Life Dental Group, LLC
Annual Report LLC Filed 2023-03-29 Annual Report For Life Dental Group, LLC
Amendment Form Filed 2022-02-22 Amendment For Life Dental Group, LLC
Annual Report LLC Filed 2022-02-22 Annual Report For Life Dental Group, LLC
Annual Report LLC Filed 2021-09-22 Annual Report For Life Dental Group, LLC
Notice to Dissolve/Revoke Filed 2021-09-07 Notice of Intent to Dissolve: AR: Life Dental Group, LLC
Annual Report LLC Filed 2020-02-06 Annual Report For Life Dental Group, LLC
Annual Report LLC Filed 2019-02-04 Annual Report For Life Dental Group, LLC
Annual Report LLC Filed 2018-02-09 Annual Report For Life Dental Group, LLC
Formation Form Filed 2017-05-26 Formation For Life Dental Group, LLC

Date of last update: 14 Jan 2025

Sources: Mississippi Secretary of State