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SMITH FAMILY DENTAL ASSOCIATES, INC.

Company Details

Name: SMITH FAMILY DENTAL ASSOCIATES, INC.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 11 Mar 1999 (26 years ago)
Identification Number: 000105302
ZIP code: 02914
County: Providence County
Principal Address: 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914, USA
Purpose: FAMILY DENTAL
NAICS: 621210 - Offices of Dentists

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SMITH FAMILY DENTAL ASSOCIATES INC. 401(K) PLAN 2023 050506688 2024-07-09 SMITH FAMILY DENTAL ASSOCIATES, INC. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2024-07-09
Name of individual signing MICHELLE GONCALVES, DMD
Valid signature Filed with authorized/valid electronic signature
SMITH FAMILY DENTAL ASSOCIATES INC. 401(K) PLAN 2022 050506688 2023-07-17 SMITH FAMILY DENTAL ASSOCIATES, INC. 15
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2023-07-17
Name of individual signing MICHELLE GONCALVES, DMD
Valid signature Filed with authorized/valid electronic signature
SMITH FAMILY DENTAL ASSOCIATES INC. 401(K) PLAN 2021 050506688 2022-08-01 SMITH FAMILY DENTAL ASSOCIATES, INC. 15
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2022-08-01
Name of individual signing MICHELLE GONCALVES, DMD
Valid signature Filed with authorized/valid electronic signature
SMITH FAMILY DENTAL ASSOCIATES INC. 401(K) PLAN 2020 050506688 2021-06-30 SMITH FAMILY DENTAL ASSOCIATES INC. 15
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2021-06-30
Name of individual signing NICOLE STECKLER, DMD
Valid signature Filed with authorized/valid electronic signature
SMITH FAMILY DENTAL ASSOCIATES INC. 401(K) PLAN 2019 050506688 2020-07-29 SMITH FAMILY DENTAL ASSOCIATES INC. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2020-07-29
Name of individual signing NICOLE STECKLER, DMD
Valid signature Filed with authorized/valid electronic signature
SMITH FAMILY DENTAL ASSOCIATES INC. 401(K) PLAN 2018 050506688 2019-07-29 SMITH FAMILY DENTAL ASSOCIATES INC. 16
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2019-07-29
Name of individual signing NICOLE STECKLER, DMD
Valid signature Filed with authorized/valid electronic signature
SMITH FAMILY DENTAL ASSOCIATES INC. 401(K) PLAN 2017 050506688 2018-07-24 SMITH FAMILY DENTAL ASSOCIATES INC. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2018-07-24
Name of individual signing NICOLE STECKLER, DMD
Valid signature Filed with authorized/valid electronic signature
SMITH FAMILY DENTAL ASSOCIATES INC. 401(K) PLAN 2016 050506688 2017-07-03 SMITH FAMILY DENTAL ASSOCIATES INC. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2017-07-03
Name of individual signing NICOLE STECKLER, DMD
Valid signature Filed with authorized/valid electronic signature
SMITH FAMILY DENTAL ASSOCIATES INC. 401(K) PLAN 2015 050506688 2016-06-14 SMITH FAMILY DENTAL ASSOCIATES INC. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2016-06-14
Name of individual signing NICOLE STECKLER, DMD
Valid signature Filed with authorized/valid electronic signature
SMITH FAMILY DENTAL ASSOCIATES INC. 401(K) PLAN 2014 050506688 2015-06-24 SMITH FAMILY DENTAL ASSOCIATES INC. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2015-06-24
Name of individual signing NICOLE STECKLER, DMD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/23/20140723130255P040052270903001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2014-07-23
Name of individual signing NICOLE STECKLER, DMD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/08/21/20130821130634P030129794469001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2013-08-21
Name of individual signing NICOLE STECKLER, DMD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/30/20120730103702P040018056546001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2012-07-30
Name of individual signing NICOLE STECKLER, DMD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/08/20110708094731P040418548432001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2011-07-08
Name of individual signing NICOLE STECKLER, DMD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-08
Name of individual signing NICOLE STECKLER, DMD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/21/20100721163857P040388984801001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621210
Sponsor’s telephone number 4014347471
Plan sponsor’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address

Administrator’s EIN 050506688
Plan administrator’s name SMITH FAMILY DENTAL ASSOCIATES INC.
Plan administrator’s address 2780 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014347471

Signature of

Role Plan administrator
Date 2010-07-21
Name of individual signing NICOLE STECKLER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MARTIN P. SLEPKOW, ESQ. Agent 1481 WAMPANOAG TRAIL, EAST PROVIDENCE, RI, 02915, USA

PRESIDENT

Name Role Address
MICHELLE D SMITH-GONCALVES PRESIDENT 2780 PAWTUCKET AVENUE EAST PROVIDENCE, RI 02914 USA

Filings

Number Name File Date
202444349080 Annual Report 2024-01-18
202328673980 Annual Report 2023-02-14
202215544700 Annual Report 2022-04-21
202189955890 Annual Report 2021-02-04
202034743010 Annual Report 2020-02-18
201988836140 Annual Report 2019-03-15
201857744310 Annual Report 2018-02-06
201731123370 Annual Report 2017-01-30
201693655890 Annual Report 2016-03-03
201554565010 Annual Report 2015-02-04

Date of last update: 08 Oct 2024

Sources: Rhode Island Department of State