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Coffman Dental, LLC

Contents

Company Details

Name: Coffman Dental, LLC
Jurisdiction: Alaska
Legal type: Limited Liability Company
Status: Good Standing
Date of registration: 19 Mar 2019 (6 years ago)
Entity Number: 10102304
ZIP code: 99654
County: Matanuska Susitna
Place of Formation: ALASKA
Address: 351 W. SWANSON AVE, STE 1, WASILLA, AK 99654-6853
Mailing Address: 351 W SWANSON AVE , SUITE 1, WASILLA, AK 99654-6853

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

621210 OFFICES OF DENTISTS

Officers

Name Role
Justin Coffman Registered Agent
Justin Coffman Member

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
WASILLA DENTAL CENTER 401(K) PLAN 2023 834035959 2024-09-17 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Sponsor COFFMAN DENTAL, LLC
Business code 621210
Sponsor’s telephone number 9073765315
Plan sponsor’s address 351 W SWANSON AVE #1, WASILLA, AK, 99654

Signature of

Role Plan administrator
Date 2024-09-17
Name of individual signing JUSTIN COFFMAN
Valid signature Filed with authorized/valid electronic signature
WASILLA DENTAL CENTER 401(K) PLAN 2022 834035959 2023-09-17 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Sponsor COFFMAN DENTAL, LLC
Business code 621210
Sponsor’s telephone number 9073765315
Plan sponsor’s address 351 W SWANSON AVE #1, WASILLA, AK, 99654

Signature of

Role Plan administrator
Date 2023-09-17
Name of individual signing JUSTIN COFFMAN
WASILLA DENTAL CENTER 401(K) PLAN 2021 834035959 2022-10-11 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Sponsor COFFMAN DENTAL, LLC
Business code 621210
Sponsor’s telephone number 9073765315
Plan sponsor’s address 351 W SWANSON AVE #1, WASILLA, AK, 99654

Signature of

Role Plan administrator
Date 2022-10-11
Name of individual signing JUSTIN COFFMAN

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Business License 2088659 Active 2019-06-12 2022-11-29 2024-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 621210 - OFFICES OF DENTISTS

Date of last update: 11 Jan 2025

Sources: State of Alaska - Department of Commerce, Community, and Economic Development