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  5. HUGH C. SMITH, JR., DENTAL CLINIC, P.A.

HUGH C. SMITH, JR., DENTAL CLINIC, P.A.

Company Details

Name: HUGH C. SMITH, JR., DENTAL CLINIC, P.A.
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Dissolved
Effective Date: 27 Sep 1994 (31 years ago)
Business ID: 611103
ZIP code: 38732
County: Bolivar
State of Incorporation: MISSISSIPPI
Principal Office Address: 511 ROBINSON DRIVE, HOSPITAL DRIVECLEVELAND, MS 38732

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HUGH C. SMITH, JR. DENTAL CLINIC, P.A. DEFINED BENEFIT PLAN 2019 640851165 2020-02-11 HUGH C. SMITH, JR. DENTAL CLINIC, P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6628435011
Plan sponsor’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358

Plan administrator’s name and address
Administrator’s EIN 640851165
Plan administrator’s name HUGH C. SMITH, JR. DENTAL CLINIC, P.A.
Plan administrator’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358
Administrator’s telephone number 6628435011

Signature of
Role Plan administrator
Date 2020-02-11
Name of individual signing HUGH SMITH
Valid signature Filed with authorized/valid electronic signature
HUGH C. SMITH, JR. DENTAL CLINIC, P.A. DEFINED BENEFIT PLAN 2018 640851165 2019-04-11 HUGH C. SMITH, JR. DENTAL CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6628435011
Plan sponsor’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358

Plan administrator’s name and address
Administrator’s EIN 640851165
Plan administrator’s name HUGH C. SMITH, JR. DENTAL CLINIC, P.A.
Plan administrator’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358
Administrator’s telephone number 6628435011

Signature of
Role Plan administrator
Date 2019-04-11
Name of individual signing HUGH SMITH
Valid signature Filed with authorized/valid electronic signature
HUGH C. SMITH, JR. DENTAL CLINIC, P.A. DEFINED BENEFIT PLAN 2017 640851165 2018-10-07 HUGH C. SMITH, JR. DENTAL CLINIC, P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6628435011
Plan sponsor’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358

Plan administrator’s name and address
Administrator’s EIN 640851165
Plan administrator’s name HUGH C. SMITH, JR. DENTAL CLINIC, P.A.
Plan administrator’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358
Administrator’s telephone number 6628435011

Signature of
Role Plan administrator
Date 2018-10-07
Name of individual signing HUGH SMITH
Valid signature Filed with authorized/valid electronic signature
HUGH C. SMITH, JR. DENTAL CLINIC, P.A. DEFINED BENEFIT PLAN 2016 640851165 2017-07-12 HUGH C. SMITH, JR. DENTAL CLINIC, P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6628435011
Plan sponsor’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358

Plan administrator’s name and address
Administrator’s EIN 640851165
Plan administrator’s name HUGH C. SMITH, JR. DENTAL CLINIC, P.A.
Plan administrator’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358
Administrator’s telephone number 6628435011

Signature of
Role Plan administrator
Date 2017-07-12
Name of individual signing HUGH SMITH
Valid signature Filed with authorized/valid electronic signature
HUGH C. SMITH, JR. DENTAL CLINIC, P.A. DEFINED BENEFIT PLAN 2015 640851165 2016-09-06 HUGH C. SMITH, JR. DENTAL CLINIC, P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6628435011
Plan sponsor’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358

Plan administrator’s name and address
Administrator’s EIN 640851165
Plan administrator’s name HUGH C. SMITH, JR. DENTAL CLINIC, P.A.
Plan administrator’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358
Administrator’s telephone number 6628435011

Signature of
Role Plan administrator
Date 2016-09-06
Name of individual signing HUGH SMITH
Valid signature Filed with authorized/valid electronic signature
HUGH C. SMITH, JR. DENTAL CLINIC, P.A. DEFINED BENEFIT PLAN 2014 640851165 2015-08-05 HUGH C. SMITH, JR. DENTAL CLINIC, P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6628435011
Plan sponsor’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358

Plan administrator’s name and address
Administrator’s EIN 640851165
Plan administrator’s name HUGH C. SMITH, JR. DENTAL CLINIC, P.A.
Plan administrator’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358
Administrator’s telephone number 6628435011

Signature of
Role Plan administrator
Date 2015-08-05
Name of individual signing HUGH SMITH
Valid signature Filed with authorized/valid electronic signature
HUGH C. SMITH, JR. DENTAL CLINIC, P.A. DEFINED BENEFIT PLAN 2013 640851165 2014-07-21 HUGH C. SMITH, JR. DENTAL CLINIC, P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6628435011
Plan sponsor’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358

Plan administrator’s name and address
Administrator’s EIN 640851165
Plan administrator’s name HUGH C. SMITH, JR. DENTAL CLINIC, P.A.
Plan administrator’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358
Administrator’s telephone number 6628435011

Signature of
Role Plan administrator
Date 2014-07-21
Name of individual signing HUGH SMITH
Valid signature Filed with authorized/valid electronic signature
HUGH C. SMITH, JR. DENTAL CLINIC, P.A. DEFINED BENEFIT PLAN 2012 640851165 2013-09-23 HUGH C. SMITH, JR. DENTAL CLINIC, P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6628435011
Plan sponsor’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358

Plan administrator’s name and address
Administrator’s EIN 640851165
Plan administrator’s name HUGH C. SMITH, JR. DENTAL CLINIC, P.A.
Plan administrator’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358
Administrator’s telephone number 6628435011

Signature of
Role Plan administrator
Date 2013-09-23
Name of individual signing HUGH SMITH
Valid signature Filed with authorized/valid electronic signature
HUGH C. SMITH, JR. DENTAL CLINIC, P.A. DEFINED BENEFIT PLAN 2011 640851165 2012-06-08 HUGH C. SMITH, JR. DENTAL CLINIC, P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6628435011
Plan sponsor’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358

Plan administrator’s name and address
Administrator’s EIN 640851165
Plan administrator’s name HUGH C. SMITH, JR. DENTAL CLINIC, P.A.
Plan administrator’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358
Administrator’s telephone number 6628435011

Signature of
Role Plan administrator
Date 2012-06-08
Name of individual signing HUGH SMITH
Valid signature Filed with authorized/valid electronic signature
HUGH C. SMITH, JR. DENTAL CLINIC, P.A. DEFINED BENEFIT PLAN 2010 640851165 2011-10-17 HUGH C. SMITH, JR. DENTAL CLINIC, P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6628435011
Plan sponsor’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358

Plan administrator’s name and address
Administrator’s EIN 640851165
Plan administrator’s name HUGH C. SMITH, JR. DENTAL CLINIC, P.A.
Plan administrator’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358
Administrator’s telephone number 6628435011

Signature of
Role Plan administrator
Date 2011-10-17
Name of individual signing HUGH SMITH
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/09/23/20100923105958P070008079009001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6628435011
Plan sponsor’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358

Plan administrator’s name and address
Administrator’s EIN 640851165
Plan administrator’s name HUGH C. SMITH, JR. DENTAL CLINIC, P.A.
Plan administrator’s address 303 HOSPITAL DR, CLEVELAND, MS, 387322358
Administrator’s telephone number 6628435011

Signature of
Role Plan administrator
Date 2010-09-23
Name of individual signing HUGH SMITH
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
HUGH C SMITH JR Agent 511 ROBINSON DRIVE, CLEVELAND, MS 38732

Incorporator

Name Role Address
Bertha P Neal Incorporator 106 S Pearman Avenue, P O Box 1209, Cleveland, MS 38732
Carolyn P Burke Incorporator 106 S Pearman Avenue, P O Box 1209, Cleveland, MS 38732

Director

Name Role Address
Hugh C Smith Jr Director 511 Robinson Dr, Cleveland, MS 38732
Diane O Smith Director 511 Robinson_dr, Cleveland, MS 38732

President

Name Role Address
Hugh C Smith Jr President 511 Robinson Dr, Cleveland, MS 38732

Secretary

Name Role Address
Diane O Smith Secretary 511 Robinson_dr, Cleveland, MS 38732

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2020-11-27 Action of HUGH C. SMITH, JR., DENTAL CLINIC, P.A.: AR
Notice to Dissolve/Revoke Filed 2020-08-28 Notice to Dissolve/Revoke
Annual Report Filed 2019-05-06 Annual Report For HUGH C. SMITH, JR., DENTAL CLINIC, P.A.
Annual Report Filed 2018-04-06 Annual Report For HUGH C. SMITH, JR., DENTAL CLINIC, P.A.
Annual Report Filed 2017-07-25 Annual Report For HUGH C. SMITH, JR., DENTAL CLINIC, P.A.
Annual Report Filed 2016-04-16 Annual Report For HUGH C. SMITH, JR., DENTAL CLINIC, P.A.
Annual Report Filed 2015-04-13 Annual Report For HUGH C. SMITH, JR., DENTAL CLINIC, P.A.
Annual Report Filed 2014-04-05 Annual Report
Annual Report Filed 2013-04-29 Annual Report
Annual Report Filed 2012-04-16 Annual Report

Related by officers

Bertha P Neal

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Carolyn P Burke

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Related by address

No related companies by address

Date of last update: 15 Mar 2025

Sources: Mississippi Secretary of State

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