|
PEDIATRIC DENTAL GROUP OF HATTIESBURG RETIREMENT PLAN & TRUST
|
2023
|
453987427
|
2024-07-24
|
PEDIATRIC DENTAL GROUP OF HATTIESBURG, PLLC
|
48
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-10-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6014506060
|
| Plan sponsor’s
address |
6643 HWY 98, HATTIESBURG, MS, 39402
|
Signature of
| Role |
Plan administrator |
| Date |
2024-07-24 |
| Name of individual signing |
ANDREW MIDDLETON, D.M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PEDIATRIC DENTAL GROUP OF HATTIESBURG RETIREMENT PLAN & TRUST
|
2022
|
453987427
|
2023-10-03
|
PEDIATRIC DENTAL GROUP OF HATTIESBURG, PLLC
|
49
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-10-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6014506060
|
| Plan sponsor’s
address |
6643 HIGHWAY 98, HATTIESBURG, MS, 39402
|
Signature of
| Role |
Plan administrator |
| Date |
2023-10-03 |
| Name of individual signing |
ANDREW MIDDLETON, D.M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PEDIATRIC DENTAL GROUP OF HATTIESBURG RETIREMENT PLAN & TRUST
|
2021
|
453987427
|
2022-06-20
|
PEDIATRIC DENTAL GROUP OF HATTIESBURG, PLLC
|
54
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-10-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6014506060
|
| Plan sponsor’s
address |
6643 HIGHWAY 98, HATTIESBURG, MS, 39402
|
Signature of
| Role |
Plan administrator |
| Date |
2022-06-20 |
| Name of individual signing |
ANDREW MIDDLETON, D.M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PEDIATRIC DENTAL GROUP OF HATTIESBURG RETIREMENT PLAN & TRUST
|
2020
|
453987427
|
2021-12-07
|
PEDIATRIC DENTAL GROUP OF HATTIESBURG, PLLC
|
46
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-10-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6014506060
|
| Plan sponsor’s
address |
6643 HIGHWAY 98, HATTIESBURG, MS, 39402
|
Signature of
| Role |
Plan administrator |
| Date |
2021-12-07 |
| Name of individual signing |
ANDREW MIDDLETON, D.M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PEDIATRIC DENTAL GROUP OF HATTIESBURG RETIREMENT PLAN & TRUST
|
2020
|
453987427
|
2021-10-01
|
PEDIATRIC DENTAL GROUP OF HATTIESBURG, PLLC
|
46
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-10-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6014506060
|
| Plan sponsor’s
address |
6643 HIGHWAY 98, HATTIESBURG, MS, 39402
|
Signature of
| Role |
Plan administrator |
| Date |
2021-10-01 |
| Name of individual signing |
ANDREW MIDDLETON, D.M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PEDIATRIC DENTAL GROUP OF HATTIESBURG RETIREMENT PLAN & TRUST
|
2019
|
453987427
|
2020-10-12
|
PEDIATRIC DENTAL GROUP OF HATTIESBURG, PLLC
|
42
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-10-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6014506060
|
| Plan sponsor’s
address |
6643 HIGHWAY 98, HATTIESBURG, MS, 39402
|
Signature of
| Role |
Plan administrator |
| Date |
2020-10-12 |
| Name of individual signing |
ANDREW MIDDLETON, D.M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PEDIATRIC DENTAL GROUP OF HATTIESBURG RETIREMENT PLAN & TRUST
|
2018
|
453987427
|
2019-09-11
|
PEDIATRIC DENTAL GROUP OF HATTIESBURG, PLLC
|
36
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2004-10-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
6014506060
|
| Plan sponsor’s
address |
6643 HIGHWAY 98, HATTIESBURG, MS, 39402
|
Signature of
| Role |
Plan administrator |
| Date |
2019-09-11 |
| Name of individual signing |
ANDREW MIDDLETON, D.M.D. |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
