DANIEL A. BERTOCH, D.D.S., P.A.

Company Details

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

DANIEL A. BERTOCH, D.D.S., P.A. RETIREMENT PLAN & TRUST

2011

592166555

2012-07-05

DANIEL A. BERTOCH, D.D.S., P.A.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8138337115
Plan sponsor’s address	4401 CARROLLWOOD VILLAGE DRIVE, TAMPA, FL, 33618

Plan administrator’s name and address

Administrator’s EIN	592166555
Plan administrator’s name	DANIEL A. BERTOCH, D.D.S., P.A.
Plan administrator’s address	4401 CARROLLWOOD VILLAGE DRIVE, TAMPA, FL, 33618
Administrator’s telephone number	8138337115

Signature of

Role	Plan administrator
Date	2012-07-05
Name of individual signing	KAY BERTOCH
Valid signature	Filed with authorized/valid electronic signature

Name	Role	Address
BERTOCH CARL A	Agent	7655 W GULF TO LAKE HWY, CRYSTAL RIVER, FL, 34429

Name	Role	Address
BERTOCH DANIEL A	President	10830 SHELDON ROAD, TAMPA, FL, 33626

Name	Role	Address
BERTOCH CARL A	Secretary	7655 W GULF TO LAKE HWY, STE 138, CRYSTAL RIVER, FL, 34429

Name	Role	Address
BERTOCH CARL A	Treasurer	7655 W GULF TO LAKE HWY, STE 138, CRYSTAL RIVER, FL, 34429

Event Type	Filed Date	Value	Description
ADMIN DISSOLUTION FOR ANNUAL REPORT	2011-09-23	No data	No data

Date of last update: 01 Jan 2025