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  5. SAMUEL GOODLOE III, DDS, MD, PLLC

SAMUEL GOODLOE III, DDS, MD, PLLC

Company Details

Name: SAMUEL GOODLOE III, DDS, MD, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 02 Jul 2010 (15 years ago)
Entity Number: 3968996
ZIP code: 14221
County: Erie
Place of Formation: New York
Address: 66 SANDHURST LANE, WILLIAMSVILLE, NY, United States, 14221

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SAMUEL GOODLOE, III, DDS, MD, PLLC 401(K) PLAN 2023 273004353 2024-07-09 SAMUEL GOODLOE, III, DDS, MD, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 7166260001
Plan sponsor’s address 1321 MILLERSPORT HIGHWAY, SUITE 201, WILLIAMSVILLE, NY, 14221

Signature of
Role Plan administrator
Date 2024-07-08
Name of individual signing SAMUEL GOODLOE III DDS MD
Role Employer/plan sponsor
Date 2024-07-08
Name of individual signing SAMUEL GOODLOE III DDS MD
SAMUEL GOODLOE, III, DDS, MD, PLLC 401(K) PLAN 2022 273004353 2023-07-24 SAMUEL GOODLOE, III, DDS, MD, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 7166260001
Plan sponsor’s address 1321 MILLERSPORT HIGHWAY, SUITE 201, WILLIAMSVILLE, NY, 14221

Signature of
Role Plan administrator
Date 2023-07-21
Name of individual signing SAMUEL GOODLOE III
Role Employer/plan sponsor
Date 2023-07-21
Name of individual signing SAMUEL GOODLOE III
SAMUEL GOODLOE, III, DDS, MD, PLLC 401(K) PLAN 2021 273004353 2022-06-22 SAMUEL GOODLOE, III, DDS, MD, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 7166260001
Plan sponsor’s address 1321 MILLERSPORT HIGHWAY, SUITE 201, WILLIAMSVILLE, NY, 14221

Signature of
Role Plan administrator
Date 2022-06-20
Name of individual signing SAMUEL GOODLOE III DDS MD
Role Employer/plan sponsor
Date 2022-06-20
Name of individual signing SAMUEL GOODLOE III DDS MD
SAMUEL GOODLOE, III, DDS, MD, PLLC 401(K) PLAN 2020 273004353 2021-06-29 SAMUEL GOODLOE, III, DDS, MD, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 7166260001
Plan sponsor’s address 1321 MILLERSPORT HIGHWAY, SUITE 201, WILLIAMSVILLE, NY, 14221

Signature of
Role Plan administrator
Date 2021-06-28
Name of individual signing SAMUEL GOODLOE III
Role Employer/plan sponsor
Date 2021-06-28
Name of individual signing SAMUEL GOODLOE III
SAMUEL GOODLOE, III, DDS, MD, PLLC 401(K) PLAN 2019 273004353 2020-07-06 SAMUEL GOODLOE, III, DDS, MD, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 7166260001
Plan sponsor’s address 1321 MILLERSPORT HIGHWAY, SUITE 201, WILLIAMSVILLE, NY, 14221

Signature of
Role Plan administrator
Date 2020-07-05
Name of individual signing SAMUEL GOODLOE III
Role Employer/plan sponsor
Date 2020-07-05
Name of individual signing SAMUEL GOODLOE III
SAMUEL GOODLOE, III, DDS, MD, PLLC 401(K) PLAN 2018 273004353 2019-07-16 SAMUEL GOODLOE, III, DDS, MD, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 7166260001
Plan sponsor’s address 1321 MILLERSPORT HIGHWAY, SUITE 201, WILLIAMSVILLE, NY, 14221

Signature of
Role Plan administrator
Date 2019-07-15
Name of individual signing SAMUEL GOODLOE III
Role Employer/plan sponsor
Date 2019-07-15
Name of individual signing SAMUEL GOODLOE III
SAMUEL GOODLOE, III, DDS, MD, PLLC 401(K) PLAN 2017 273004353 2018-04-23 SAMUEL GOODLOE, III, DDS, MD, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 7166260001
Plan sponsor’s address 1321 MILLERSPORT HIGHWAY, SUITE 201, WILLIAMSVILLE, NY, 14221

Signature of
Role Plan administrator
Date 2018-04-22
Name of individual signing SAMUEL GOODLOE III
Role Employer/plan sponsor
Date 2018-04-22
Name of individual signing SAMUEL GOODLOE III

DOS Process Agent

Name Role Address
SAMUEL GOODLOE, III DOS Process Agent 66 SANDHURST LANE, WILLIAMSVILLE, NY, United States, 14221

Filings

Filing Number Date Filed Type Effective Date
120709006972 2012-07-09 BIENNIAL STATEMENT 2012-07-01
110218000089 2011-02-18 CERTIFICATE OF PUBLICATION 2011-02-18
100702000020 2010-07-02 ARTICLES OF ORGANIZATION 2010-07-02

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 30 Dec 2024

Sources: New York Secretary of State

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