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POLASKI DENTAL GROUP, PLLC

Company Details

Name: POLASKI DENTAL GROUP, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 08 Jun 1995 (29 years ago)
Entity Number: 1929256
ZIP code: 12477
County: Ulster
Place of Formation: New York
Address: 8 ULSTER AVENUE, SAUGERTIES, NY, United States, 12477

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
POLASKI DENTAL GROUP PLLC 401(K) PLAN 2023 141783555 2024-07-31 POLASKI DENTAL GROUP PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 8452463070
Plan sponsor’s address 8 ULSTER AVENUE, SAUGERTIES, NY, 12477

Signature of

Role Plan administrator
Date 2024-07-31
Name of individual signing FARAH POLASKI
Role Employer/plan sponsor
Date 2024-07-31
Name of individual signing FARAH POLASKI
POLASKI DENTAL GROUP PLLC 401(K) PLAN 2022 141783555 2023-07-31 POLASKI DENTAL GROUP PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 8452463070
Plan sponsor’s address 8 ULSTER AVENUE, SAUGERTIES, NY, 12477

Signature of

Role Plan administrator
Date 2023-07-31
Name of individual signing FARAH POLASKI
Role Employer/plan sponsor
Date 2023-07-31
Name of individual signing FARAH POLASKI
POLASKI DENTAL GROUP PLLC 401(K) PLAN 2021 141783555 2022-10-14 POLASKI DENTAL GROUP PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 8452463070
Plan sponsor’s address 8 ULSTER AVENUE, SAUGERTIES, NY, 12477

Signature of

Role Plan administrator
Date 2022-10-14
Name of individual signing FARAH POLASKI
POLASKI DENTAL GROUP PLLC 401(K) PLAN 2020 141783555 2021-10-15 POLASKI DENTAL GROUP PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 8452463070
Plan sponsor’s address 8 ULSTER AVENUE, SAUGERTIES, NY, 12477

Signature of

Role Plan administrator
Date 2021-10-15
Name of individual signing FARAH POLASKI
POLASKI DENTAL GROUP PLLC 401(K) PLAN 2019 141783555 2020-10-13 POLASKI DENTAL GROUP PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 8452463070
Plan sponsor’s address 8 ULSTER AVENUE, SAUGERTIES, NY, 12477

Signature of

Role Plan administrator
Date 2020-10-13
Name of individual signing FARAH POLASKI
POLASKI DENTAL GROUP PLLC 401(K) PLAN 2018 141783555 2019-08-20 POLASKI DENTAL GROUP PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 8452463070
Plan sponsor’s address 8 ULSTER AVENUE, SAUGERTIES, NY, 12477

Signature of

Role Plan administrator
Date 2019-08-20
Name of individual signing FARAH POLASKI
POLASKI DENTAL GROUP PLLC 401(K) PLAN 2017 141783555 2018-09-27 POLASKI DENTAL GROUP PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 8452463070
Plan sponsor’s address 8 ULSTER AVENUE, SAUGERTIES, NY, 12477

Signature of

Role Plan administrator
Date 2018-09-27
Name of individual signing FARAH POLASKI
POLASKI DENTAL GROUP PLLC 401(K) PLAN 2016 141783555 2017-06-01 POLASKI DENTAL GROUP PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 8452463070
Plan sponsor’s address 8 ULSTER AVENUE, SAUGERTIES, NY, 12477

Signature of

Role Plan administrator
Date 2017-06-01
Name of individual signing FARAH POLASKI
POLASKI DENTAL GROUP PLLC 401(K) PLAN 2015 141783555 2016-07-19 POLASKI DENTAL GROUP PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 8452463070
Plan sponsor’s address 8 ULSTER AVENUE, SAUGERTIES, NY, 12477

Signature of

Role Plan administrator
Date 2016-07-19
Name of individual signing FARAH POLASKI
POLASKI DENTAL GROUP PLLC 401(K) PLAN 2014 141783555 2015-07-08 POLASKI DENTAL GROUP PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 8452463070
Plan sponsor’s address 8 ULSTER AVENUE, SAUGERTIES, NY, 12477

Signature of

Role Plan administrator
Date 2015-07-08
Name of individual signing FARAH POLASKI

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 8 ULSTER AVENUE, SAUGERTIES, NY, United States, 12477

History

Start date End date Type Value
1997-06-18 2017-11-16 Address ROUTE 9W, BOX 378, LAKE KATRINE, NY, 12449, USA (Type of address: Service of Process)
1995-06-08 1997-06-18 Address 673 W SAUGERTIES WOODSTOCK RD, SAUGERTIES, NY, 12477, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
171116002033 2017-11-16 BIENNIAL STATEMENT 2017-06-01
010613002278 2001-06-13 BIENNIAL STATEMENT 2001-06-01
990603002030 1999-06-03 BIENNIAL STATEMENT 1999-06-01
970618002636 1997-06-18 BIENNIAL STATEMENT 1997-06-01
950608000555 1995-06-08 ARTICLES OF ORGANIZATION 1995-06-08

Date of last update: 13 Nov 2024

Sources: New York Secretary of State