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  5. SILVER LAKE DENTAL PLLC

SILVER LAKE DENTAL PLLC

Company Details

Name: SILVER LAKE DENTAL PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 14 Jan 2011 (14 years ago)
Entity Number: 4042769
ZIP code: 14530
County: Wyoming
Place of Formation: New York
Address: 114 NORTH CENTER STREET, PERRY, NY, United States, 14530

Contact Details

Phone +1 585-237-3530

Phone +1 585-468-2610

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SILVER LAKE DENTAL PLLC 401(K) PROFIT SHARING PLAN 2023 274654652 2024-06-10 SILVER LAKE DENTAL PLLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 5852373530
Plan sponsor’s address 114 N. CENTER STREET, PERRY, NY, 14530

Signature of
Role Plan administrator
Date 2024-06-05
Name of individual signing TIMOTHY DERUYTER
SILVER LAKE DENTAL PLLC 401(K) PROFIT SHARING PLAN 2022 274654652 2023-06-28 SILVER LAKE DENTAL PLLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 5852373530
Plan sponsor’s address 114 N. CENTER STREET, PERRY, NY, 14530

Signature of
Role Plan administrator
Date 2023-06-28
Name of individual signing TIMOTHY DERUYTER
SILVER LAKE DENTAL PLLC 401(K) PROFIT SHARING PLAN 2021 274654652 2022-07-21 SILVER LAKE DENTAL PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 5852373530
Plan sponsor’s address 114 N. CENTER STREET, PERRY, NY, 14530

Signature of
Role Plan administrator
Date 2022-07-21
Name of individual signing TIMOTHY DERUYTER
SILVER LAKE DENTAL PLLC 401(K) PROFIT SHARING PLAN 2020 274654652 2021-05-04 SILVER LAKE DENTAL PLLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 5852373530
Plan sponsor’s address 114 N. CENTER STREET, PERRY, NY, 14530

Signature of
Role Plan administrator
Date 2021-04-28
Name of individual signing TIMOTHY DERUYTER
SILVER LAKE DENTAL PLLC 401(K) PROFIT SHARING PLAN 2019 274654652 2020-07-15 SILVER LAKE DENTAL PLLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 5852373530
Plan sponsor’s address 114 N. CENTER STREET, PERRY, NY, 14530

Signature of
Role Plan administrator
Date 2020-07-15
Name of individual signing TIMOTHY DERUYTER
SILVER LAKE DENTAL PLLC 401(K) PROFIT SHARING PLAN 2018 274654652 2019-05-16 SILVER LAKE DENTAL PLLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 5852373530
Plan sponsor’s address 114 N. CENTER STREET, PERRY, NY, 14530

Signature of
Role Plan administrator
Date 2019-05-16
Name of individual signing TIMOTHY DERUYTER
SILVER LAKE DENTAL PLLC 401(K) PROFIT SHARING PLAN 2017 274654652 2018-04-23 SILVER LAKE DENTAL PLLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 541990
Sponsor’s telephone number 5852373530
Plan sponsor’s address 114 N. CENTER STREET, PERRY, NY, 14530

Signature of
Role Plan administrator
Date 2018-04-20
Name of individual signing TIMOTHY DERUYTER
SILVER LAKE DENTAL PLLC 401 K PROFIT SHARING PLAN TRUST 2016 274654652 2017-06-27 SILVER LAKE DENTAL PLLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 541990
Sponsor’s telephone number 5852373530
Plan sponsor’s address 114 NORTH CENTER ST., PERRY, NY, 14530

Signature of
Role Plan administrator
Date 2017-06-27
Name of individual signing TIMOTHY J DERUYTER
SILVER LAKE DENTAL PLLC 401 K PROFIT SHARING PLAN TRUST 2015 274654652 2016-07-07 SILVER LAKE DENTAL PLLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 541990
Sponsor’s telephone number 5852373530
Plan sponsor’s address 114 NORTH CENTER ST., PERRY, NY, 14530

Signature of
Role Plan administrator
Date 2016-07-07
Name of individual signing TIMOTHY J DERUYTER
SILVER LAKE DENTAL PLLC 401 K PROFIT SHARING PLAN TRUST 2014 274654652 2015-06-25 SILVER LAKE DENTAL PLLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 541990
Sponsor’s telephone number 5852373530
Plan sponsor’s address 114 NORTH CENTER ST., PERRY, NY, 14530

Signature of
Role Plan administrator
Date 2015-06-25
Name of individual signing TIMOTHY J DERUYTER

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 114 NORTH CENTER STREET, PERRY, NY, United States, 14530

Filings

Filing Number Date Filed Type Effective Date
210106060315 2021-01-06 BIENNIAL STATEMENT 2021-01-01
170110006375 2017-01-10 BIENNIAL STATEMENT 2017-01-01
150107006088 2015-01-07 BIENNIAL STATEMENT 2015-01-01
130109006178 2013-01-09 BIENNIAL STATEMENT 2013-01-01
110426000146 2011-04-26 CERTIFICATE OF PUBLICATION 2011-04-26
110114000524 2011-01-14 ARTICLES OF ORGANIZATION 2011-01-14

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
2886868303 2021-01-21 0296 PPS 114 N Center St, Perry, NY, 14530-9701
Loan Status Date 2021-09-14
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 142477.22
Loan Approval Amount (current) 142477.22
Undisbursed Amount 0
Franchise Name -
Lender Location ID 47331
Servicing Lender Name Tompkins Community Bank
Servicing Lender Address 118 East Seneca St, ITHACA, NY, 14850
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Perry, WYOMING, NY, 14530-9701
Project Congressional District NY-24
Number of Employees 14
NAICS code 621210
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 47110
Originating Lender Name Tompkins Bank of Castile, A Branch of
Originating Lender Address Castile, NY
Gender Male Owned
Veteran Veteran
Forgiveness Amount 143218.88
Forgiveness Paid Date 2021-08-06
7845137209 2020-04-28 0296 PPP 114 North CENTER ST, PERRY, NY, 14530-9701
Loan Status Date 2021-03-17
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 167900
Loan Approval Amount (current) 167900
Undisbursed Amount 0
Franchise Name -
Lender Location ID 47331
Servicing Lender Name Tompkins Community Bank
Servicing Lender Address 118 East Seneca St, ITHACA, NY, 14850
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address PERRY, WYOMING, NY, 14530-9701
Project Congressional District NY-24
Number of Employees 12
NAICS code 621210
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 47110
Originating Lender Name Tompkins Bank of Castile, A Branch of
Originating Lender Address Castile, NY
Gender Male Owned
Veteran Veteran
Forgiveness Amount 169252.4
Forgiveness Paid Date 2021-02-24

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Related by address

114 NORTH CENTER STREET, PERRY, NY, United States, 14530

NORTH CENTER PROFESSIONAL OFFICES, INC. RALPH E. FIELD, D.D.S., P.C.

Date of last update: 27 Mar 2025

Sources: New York Secretary of State

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