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  5. MONROE DENTAL OFFICE, P. C.

MONROE DENTAL OFFICE, P. C.

Company Details

Name: MONROE DENTAL OFFICE, P. C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 31 Jul 1981 (43 years ago)
Entity Number: 714557
ZIP code: 10950
County: Orange
Place of Formation: New York
Address: 400 STATE ROUTE 17M, STE 2, MONROE, NY, United States, 10950

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MONROE DENTAL OFFICE, P.C. RETIREMENT PLAN 2016 141628359 2017-09-11 MONROE DENTAL OFFICE, P.C. 17
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1997-08-01
Business code 621210
Sponsor’s telephone number 8455934042
Plan sponsor’s address 400 STATE ROUTE 17M STE 2, MONROE, NY, 109504430

Signature of
Role Plan administrator
Date 2017-09-11
Name of individual signing BOBBY CROHN
MONROE DENTAL OFFICE, P.C. RETIREMENT PLAN 2015 141628359 2016-09-02 MONROE DENTAL OFFICE, P.C. 18
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1997-08-01
Business code 621210
Sponsor’s telephone number 8455934042
Plan sponsor’s address 400 STATE ROUTE 17M STE 2, MONROE, NY, 109504430

Signature of
Role Plan administrator
Date 2016-09-02
Name of individual signing BOBBY CROHN
MONROE DENTAL OFFICE, P.C. RETIREMENT PLAN 2012 141628359 2013-12-31 MONROE DENTAL OFFICE, P.C. 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1997-08-01
Business code 621210
Sponsor’s telephone number 8457820189
Plan sponsor’s mailing address 400 STATE ROUTE 17M, SUITE 2, MONROE, NY, 10950
Plan sponsor’s address 400 STATE ROUTE 17M, SUITE 2, MONROE, NY, 10950

Plan administrator’s name and address
Administrator’s EIN 141628359
Plan administrator’s name MONROE DENTAL OFFICE, P.C.
Plan administrator’s address 400 STATE ROUTE 17M, SUITE 2, MONROE, NY, 10950
Administrator’s telephone number 8457820189

Number of participants as of the end of the plan year
Active participants 15
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 16
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2013-12-31
Name of individual signing BARBARA PERECHOCKY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-12-31
Name of individual signing BARBARA PERECHOCKY
Valid signature Filed with authorized/valid electronic signature
MONROE DENTAL OFFICE, P.C. RETIREMENT PLAN 2011 141628359 2012-10-03 MONROE DENTAL OFFICE, P.C. 18
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1997-08-01
Business code 621210
Sponsor’s telephone number 8457820189
Plan sponsor’s mailing address 400 STATE ROUTE 17M, SUITE 2, MONROE, NY, 10950
Plan sponsor’s address 400 STATE ROUTE 17M, SUITE 2, MONROE, NY, 10950

Plan administrator’s name and address
Administrator’s EIN 141628359
Plan administrator’s name MONROE DENTAL OFFICE, P.C.
Plan administrator’s address 400 STATE ROUTE 17M, SUITE 2, MONROE, NY, 10950
Administrator’s telephone number 8457820189

Number of participants as of the end of the plan year
Active participants 17
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 1
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 18
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-10-03
Name of individual signing BARBARA PERECHOCKY
Valid signature Filed with authorized/valid electronic signature
MONROE DENTAL OFFICE, P.C. RETIREMENT PLAN 2010 141628359 2011-11-02 MONROE DENTAL OFFICE, P.C. 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1997-08-01
Business code 621210
Sponsor’s telephone number 8457820189
Plan sponsor’s mailing address 400 STATE ROUTE 17M, SUITE 2, MONROE, NY, 10950
Plan sponsor’s address 400 STATE ROUTE 17M, SUITE 2, MONROE, NY, 10950

Plan administrator’s name and address
Administrator’s EIN 141628359
Plan administrator’s name MONROE DENTAL OFFICE, P.C.
Plan administrator’s address 400 STATE ROUTE 17M, SUITE 2, MONROE, NY, 10950
Administrator’s telephone number 8457820189

Number of participants as of the end of the plan year
Active participants 16
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 2
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 17
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-11-02
Name of individual signing JOSEPH PERECHOCKY
Valid signature Filed with authorized/valid electronic signature
MONROE DENTAL OFFICE, P.C. RETIREMENT PLAN 2009 141628359 2010-10-26 MONROE DENTAL OFFICE, P.C. 22
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1997-08-01
Business code 621210
Sponsor’s telephone number 8457820189
Plan sponsor’s mailing address 400 STATE ROUTE 17M, SUITE 2, MONROE, NY, 10950
Plan sponsor’s address 400 STATE ROUTE 17M, SUITE 2, MONROE, NY, 10950

Plan administrator’s name and address
Administrator’s EIN 141628359
Plan administrator’s name MONROE DENTAL OFFICE, P.C.
Plan administrator’s address 400 STATE ROUTE 17M, SUITE 2, MONROE, NY, 10950
Administrator’s telephone number 8457820189

Number of participants as of the end of the plan year
Active participants 17
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 18
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-10-26
Name of individual signing BOBBY CROHN
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 400 STATE ROUTE 17M, STE 2, MONROE, NY, United States, 10950

Chief Executive Officer

Name Role Address
DR FREDRIC KNELLER Chief Executive Officer 400 STATE ROUTE 17M, STE 2, MONROE, NY, United States, 10950

History

Start date End date Type Value
2005-06-21 2005-08-26 Address 400 STATE ROUTE 17-M SUITE #2, MONROE, NY, 10950, USA (Type of address: Service of Process)
1993-03-09 2005-08-26 Address FEDERAL PLAZA, ROUTE 17M, MONROE, NY, 10950, USA (Type of address: Chief Executive Officer)
1993-03-09 2005-08-26 Address FEDERAL PLAZA, ROUTE 17M, MONROE, NY, 10950, USA (Type of address: Principal Executive Office)
1993-03-09 2005-06-21 Address FEDERAL PLAZA, ROUTE 17M, MONROE, NY, 10950, USA (Type of address: Service of Process)
1981-07-31 1993-03-09 Address FEDERAL PLAZA, ROUTE 17M, NEW YORK, NY, 10950, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
130708007194 2013-07-08 BIENNIAL STATEMENT 2013-07-01
110722002900 2011-07-22 BIENNIAL STATEMENT 2011-07-01
090708002551 2009-07-08 BIENNIAL STATEMENT 2009-07-01
070726002127 2007-07-26 BIENNIAL STATEMENT 2007-07-01
050826002428 2005-08-26 BIENNIAL STATEMENT 2005-07-01
050621000657 2005-06-21 CERTIFICATE OF CHANGE 2005-06-21
040108002236 2004-01-08 BIENNIAL STATEMENT 2003-07-01
010705002760 2001-07-05 BIENNIAL STATEMENT 2001-07-01
990714002250 1999-07-14 BIENNIAL STATEMENT 1999-07-01
970716002504 1997-07-16 BIENNIAL STATEMENT 1997-07-01

Related by officers

THE CORPORATION

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Related by address

No related companies by address

Date of last update: 07 Jan 2025

Sources: New York Secretary of State

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