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  5. JAMIE WAYNE ODOM, D.M.D., P.A.

JAMIE WAYNE ODOM, D.M.D., P.A.

Company Details

Entity Name: JAMIE WAYNE ODOM, D.M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 10 Jul 2000 (25 years ago)
Document Number: P00000067187
FEI/EIN Number 593659078
Address: 361 East Central Avenue, Winter Haven, FL, 33880, US
Mail Address: PO BOX 3131, WINTER HAVEN, FL, 33885
ZIP code: 33880
County: Polk
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JAMIE WAYNE ODOM, D.M.D., P.A. 401(K) PLAN 2013 593659078 2014-10-15 JAMIE WAYNE ODOM, D.M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 8632590505
Plan sponsor’s address 28029 US HIGHWAY 27 SOUTH, DUNDEE, FL, 33838

Signature of
Role Plan administrator
Date 2014-10-15
Name of individual signing STEPHANIE ODOM
Valid signature Filed with authorized/valid electronic signature
JAMIE WAYNE ODOM, D.M.D., P.A. 401(K) PLAN 2012 593659078 2013-10-15 JAMIE WAYNE ODOM, D.M.D., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 8632590505
Plan sponsor’s address 28029 US HIGHWAY 27 SOUTH, DUNDEE, FL, 33838

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing JAMIE ODOM
Valid signature Filed with authorized/valid electronic signature
JAMIE WAYNE ODOM, D.M.D., P.A. 401(K) PLAN 2011 593659078 2012-10-15 JAMIE WAYNE ODOM, D.M.D., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 8632590505
Plan sponsor’s address 28029 US HIGHWAY 27 SOUTH, DUNDEE, FL, 33838

Plan administrator’s name and address
Administrator’s EIN 593659078
Plan administrator’s name JAMIE WAYNE ODOM, D.M.D., P.A.
Plan administrator’s address 28029 US HIGHWAY 27 SOUTH, DUNDEE, FL, 33838
Administrator’s telephone number 8632590505

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing JAMIE ODOM
Valid signature Filed with authorized/valid electronic signature
JAMIE WAYNE ODOM, D.M.D., P.A. 401(K) PLAN 2010 593659078 2011-10-17 JAMIE WAYNE ODOM, D.M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 8632590505
Plan sponsor’s address P.O. BOX 3131, WINTER HAVEN, FL, 33838

Plan administrator’s name and address
Administrator’s EIN 593659078
Plan administrator’s name JAMIE WAYNE ODOM, D.M.D., P.A.
Plan administrator’s address P.O. BOX 3131, WINTER HAVEN, FL, 33838
Administrator’s telephone number 8632590505

Signature of
Role Plan administrator
Date 2011-10-17
Name of individual signing JAMIE WAYNE ODOM
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SMITH VICTOR R Agent 55 5th St NW, Winter Haven, FL, 33881

Director

Name Role Address
ODOM JAMIE W Director 1320 Mirror Ter, WINTER HAVEN, FL, 33881

Related by officers

ODOM JAMIE W

THE FAMILY AND COSMETIC DENTISTRY CENTER OF THOMAS A. FELLNER, D.D.S., AND JAMIE W. ODOM, D.M.D., L.L.C.

SMITH VICTOR R

THE PEACOCK AGENCY, INC. C & K STUCCO, INC. MCCG INVESTMENTS, INC. A M D, INC. OUT, INC.

Related by address

No related companies by address

Date of last update: 02 Jan 2025

Sources: Florida Department of State

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