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  5. Advanced Cosmetic Dentistry, Ltd.

Advanced Cosmetic Dentistry, Ltd.

Company Details

Name: Advanced Cosmetic Dentistry, Ltd.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Revoked Entity
Date of Organization in Rhode Island: 03 Apr 1978 (47 years ago)
Date of Dissolution: 30 Dec 2020 (4 years ago)
Date of Status Change: 30 Dec 2020 (4 years ago)
Identification Number: 000017224
ZIP code: 02920
County: Providence County
Principal Address: 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920, USA
Purpose: DENTAL PRACTICE
NAICS: 621210 - Offices of Dentists
Historical names: PERIODONTOLOGY ASSOCIATES, LTD.

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1336398676 2008-09-11 2016-03-03 1090 NEW LONDON AVE, CRANSTON, RI, 029203035, US 1090 NEW LONDON AVE, CRANSTON, RI, 029203035, US

Contacts
Phone +1 401-943-6311
Fax 4019432030

Authorized person
Name DR. RICHARD L GLICK
Role PRESIDENT
Phone 4019436311

Taxonomy
Taxonomy Code 1223P0300X - Periodontist
State RI
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ADVANCED COSMETIC DENTISTRY, LTD 401(K) PROFIT SHARING PLAN 2019 050375503 2020-06-30 ADVANCED COSMETIC DENTISTRY LTD 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4019656311
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2020-06-30
Name of individual signing RICHARD GLICK
Valid signature Filed with authorized/valid electronic signature
ADVANCED COSMETIC DENTISTRY, LTD 401(K) PROFIT SHARING PLAN 2019 050375503 2020-06-23 ADVANCED COSMETIC DENTISTRY LTD 10
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4019656311
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2020-06-23
Name of individual signing RGLICK4318
Valid signature Filed with authorized/valid electronic signature
ADVANCED COSMETIC DENTISTRY, LTD 401(K) PROFIT SHARING PLAN 2018 050375503 2020-01-06 ADVANCED COSMETIC DENTISTRY LTD 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4019436311
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2020-01-06
Name of individual signing RICHARD GLICK
Valid signature Filed with authorized/valid electronic signature
ADVANCED COSMETIC DENTISTRY, LTD 401(K) PROFIT SHARING PLAN 2016 050375503 2017-02-08 ADVANCED COSMETIC DENTISTRY, LTD. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621399
Sponsor’s telephone number 4019436311
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
ADVANCED COSMETIC DENTISTRY, LTD 401(K) PROFIT SHARING PLAN 2015 050375503 2016-05-02 ADVANCED COSMETIC DENTISTRY, LTD. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621399
Sponsor’s telephone number 4019436311
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
ADVANCED COSMETIC DENTISTRY, LTD 401(K) PROFIT SHARING PLAN 2014 050375503 2015-07-14 ADVANCED COSMETIC DENTISTRY, LTD. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621399
Sponsor’s telephone number 4019436311
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 050375503
Plan administrator’s name ADVANCED COSMETIC DENTISTRY, LTD.
Plan administrator’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4019436311

Signature of
Role Plan administrator
Date 2015-07-14
Name of individual signing RICHARD L. GLICK
Valid signature Filed with authorized/valid electronic signature
ADVANCED COSMETIC DENTISTRY, LTD 401(K) PROFIT SHARING PLAN 2013 050375503 2014-09-16 ADVANCED COSMETIC DENTISTRY, LTD. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621399
Sponsor’s telephone number 4019436311
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 050375503
Plan administrator’s name ADVANCED COSMETIC DENTISTRY, LTD.
Plan administrator’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4019436311

Signature of
Role Plan administrator
Date 2014-09-16
Name of individual signing RICHARD L. GLICK
Valid signature Filed with authorized/valid electronic signature
ADVANCED COSMETIC DENTISTRY, LTD 401(K) PROFIT SHARING PLAN 2012 050375503 2013-09-30 ADVANCED COSMETIC DENTISTRY, LTD. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621399
Sponsor’s telephone number 4019436311
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 050375503
Plan administrator’s name ADVANCED COSMETIC DENTISTRY, LTD.
Plan administrator’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4019436311

Signature of
Role Plan administrator
Date 2013-09-30
Name of individual signing RICHARD L. GLICK
Valid signature Filed with authorized/valid electronic signature
ADVANCED COSMETIC DENTISTRY, LTD 401(K) PROFIT SHARING PLAN 2011 050375503 2012-06-18 ADVANCED COSMETIC DENTISTRY, LTD. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621399
Sponsor’s telephone number 4019436311
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 050375503
Plan administrator’s name ADVANCED COSMETIC DENTISTRY, LTD.
Plan administrator’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4019436311

Signature of
Role Plan administrator
Date 2012-06-18
Name of individual signing RICHARD L. GLICK
Valid signature Filed with authorized/valid electronic signature
ADVANCED COSMETIC DENTISTRY, LTD 401(K) PROFIT SHARING PLAN 2010 050375503 2011-10-04 ADVANCED COSMETIC DENTISTRY, LTD. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621399
Sponsor’s telephone number 4019436311
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 050375503
Plan administrator’s name ADVANCED COSMETIC DENTISTRY, LTD.
Plan administrator’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4019436311

Signature of
Role Plan administrator
Date 2011-10-04
Name of individual signing RICHARD L. GLICK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/06/23/20100623114141P040025728887001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621399
Sponsor’s telephone number 4019436311
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 050375503
Plan administrator’s name ADVANCED COSMETIC DENTISTRY, LTD.
Plan administrator’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4019436311

Signature of
Role Plan administrator
Date 2010-06-23
Name of individual signing RICHARD L. GLICK
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DR. RICHARD L. GLICK Agent 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920, USA

PRESIDENT

Name Role Address
RICHARD L GLICK DDS PRESIDENT 1090 NEW LONDON AVENUE CRANSTON, RI 02920 USA

Events

Type Date Old Value New Value
Name Change 2005-08-29 PERIODONTOLOGY ASSOCIATES, LTD. Advanced Cosmetic Dentistry, Ltd.

Filings

Number Name File Date
202082818030 Revocation Certificate For Failure to File the Annual Report for the Year 2020-12-30
202054954690 Revocation Notice For Failure to File An Annual Report 2020-09-16
201985638440 Annual Report 2019-01-31
201860296750 Annual Report 2018-03-15
201733550200 Annual Report 2017-02-06
201693358520 Annual Report 2016-02-29
201556612730 Annual Report 2015-03-05
201432470340 Annual Report 2014-01-07
201310940680 Annual Report 2013-02-05
201287764900 Annual Report 2012-01-10

Related by officers

No related officers

Related by address

1090 NEW LONDON AVENUE, CRANSTON, RI, 02920, USA

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Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State

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