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  5. ADVANCED DENTAL GROUP INC.

ADVANCED DENTAL GROUP INC.

Company Details

Entity Name: ADVANCED DENTAL GROUP INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 13 Aug 1997 (27 years ago)
Date of dissolution: 16 Oct 1998 (26 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 16 Oct 1998 (26 years ago)
Document Number: P97000070327
Address: 2534 CAPITAL MEDICAL BLVD., TALLAHASSEE, FL, 32308
Mail Address: 2534 CAPITAL MEDICAL BLVD., TALLAHASSEE, FL, 32308
ZIP code: 32308
County: Leon
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1194841593 2007-03-21 2020-08-22 5651 CORPORATE WAY, SUITE 1, WEST PALM BEACH, FL, 334072020, US 5651 CORPORATE WAY, SUITE 1, WEST PALM BEACH, FL, 334072020, US

Contacts
Phone +1 561-689-0872
Fax 5616839262

Authorized person
Name DR. THOMAS FRANCIS FRASER
Role OWNER
Phone 5616890872

Taxonomy
Taxonomy Code 1223G0001X - General Practice Dentistry
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ADVANCED DENTAL GROUP RETIREMENT PLAN & TRUST 2023 020671891 2024-07-08 ADVANCED DENTAL GROUP 15
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1971-01-22
Business code 621210
Sponsor’s telephone number 5616890872
Plan sponsor’s address 5651 CORPORATE WAY, WEST PALM BEACH, FL, 33407

Signature of
Role Plan administrator
Date 2024-07-08
Name of individual signing THOMAS F FRASER
Valid signature Filed with authorized/valid electronic signature
ADVANCED DENTAL GROUP CASH BALANCE PLAN 2023 020671891 2024-09-02 ADVANCED DENTAL GROUP 16
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 5616890872
Plan sponsor’s address 5651 CORPORATE WAY, SUITE 1, WEST PALM BEACH, FL, 33407

Signature of
Role Plan administrator
Date 2024-09-03
Name of individual signing THOMAS F. FRASER
Valid signature Filed with authorized/valid electronic signature
ADVANCED DENTAL GROUP CASH BALANCE PLAN 2022 020671891 2023-09-13 ADVANCED DENTAL GROUP 14
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 5616890872
Plan sponsor’s address 5651 CORPORATE WAY, SUITE 1, WEST PALM BEACH, FL, 33407
ADVANCED DENTAL GROUP RETIREMENT PLAN & TRUST 2022 020671891 2023-05-22 ADVANCED DENTAL GROUP 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1971-01-22
Business code 621210
Sponsor’s telephone number 5616890872
Plan sponsor’s address 5651 CORPORATE WAY, WEST PALM BEACH, FL, 33407

Signature of
Role Plan administrator
Date 2023-05-22
Name of individual signing THOMAS F FRASER
Valid signature Filed with authorized/valid electronic signature
ADVANCED DENTAL GROUP RETIREMENT PLAN & TRUST 2021 020671891 2022-08-31 ADVANCED DENTAL GROUP 16
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1971-01-22
Business code 621210
Sponsor’s telephone number 5616890872
Plan sponsor’s address 5651 CORPORATE WAY, WEST PALM BEACH, FL, 33407

Signature of
Role Plan administrator
Date 2022-08-31
Name of individual signing THOMAS F FRASER
Valid signature Filed with authorized/valid electronic signature
ADVANCED DENTAL GROUP CASH BALANCE PLAN 2021 020671891 2022-10-12 ADVANCED DENTAL GROUP 14
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 5616890872
Plan sponsor’s address 5651 CORPORATE WAY, SUITE 1, WEST PALM BEACH, FL, 33407

Signature of
Role Plan administrator
Date 2022-10-12
Name of individual signing PATRICE BAHRUTH
Valid signature Filed with authorized/valid electronic signature
ADVANCED DENTAL GROUP RETIREMENT PLAN & TRUST 2020 020671891 2021-04-19 ADVANCED DENTAL GROUP 15
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1971-01-22
Business code 621210
Sponsor’s telephone number 5616890872
Plan sponsor’s address 5651 CORPORATE WAY, WEST PALM BEACH, FL, 33407
ADVANCED DENTAL GROUP RETIREMENT PLAN & TRUST 2019 020671891 2020-03-25 ADVANCED DENTAL GROUP 16
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1971-01-22
Business code 621210
Sponsor’s telephone number 5616890872
Plan sponsor’s address 5651 CORPORATE WAY, WEST PALM BEACH, FL, 33407
ADVANCED DENTAL GROUP RETIREMENT PLAN & TRUST 2018 020671891 2019-03-12 ADVANCED DENTAL GROUP 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1971-01-22
Business code 621210
Sponsor’s telephone number 5616890872
Plan sponsor’s address 5651 CORPORATE WAY, WEST PALM BEACH, FL, 33407
ADVANCED DENTAL GROUP RETIREMENT PLAN & TRUST 2017 020671891 2018-06-18 ADVANCED DENTAL GROUP 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1971-01-22
Business code 621210
Sponsor’s telephone number 5616890872
Plan sponsor’s address 5651 CORPORATE WAY, WEST PALM BEACH, FL, 33407

Agent

Name Role Address
MONTALVO RALPH D Agent 3216 STORRINGTON DR., TALLAHASSEE, FL, 32308

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 1998-10-16 No data No data

Documents

Name Date
Domestic Profit Articles 1997-08-13

Related by officers

MONTALVO RALPH D

ADVANCED DENTAL CARE OF TALLAHASSEE, PA ADVANCED DENTAL CARE OF TALLAHASSEE, PA

Related by address

2534 CAPITAL MEDICAL BLVD., TALLAHASSEE, FL, 32308

BARKER ENTERPRISES, INC.

2534 CAPITAL MEDICAL BLVD., TALLAHASSEE, FL, 32308

BARKER ENTERPRISES, INC.

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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