Menu
Search icon

MYSTIC DENTAL GROUP, P.C.

Company Details

Entity Name: MYSTIC DENTAL GROUP, P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 05 Jul 1978 (Companies founded in July 1978)
Business ALEI: 0077313
Annual report due: 05 Jul 2025
NAICS code: 621210 - Offices of Dentists
Business address: 117 COW HILL RD., MYSTIC, CT, 06355, United States
Mailing address: 117 COW HILL RD., MYSTIC, CT, United States, 06355
ZIP code: 06355 (Companies in New London, 06355)
County: New London
Place of Formation: CONNECTICUT
Total authorized shares: 500
E-Mail: traceyturbo@aol.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MYSTIC DENTAL GROUP, P.C. 401(K) PLAN 2019 060982835 2021-10-06 MYSTIC DENTAL GROUP, P.C. 32
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1996-06-01
Business code 621210
Sponsor’s telephone number 4012846155
Plan sponsor’s address 117 COW HILL ROAD, MYSTIC, CT, 06355

Signature of
Role Plan administrator
Date 2021-10-06
Name of individual signing TRACEY WILSON
Valid signature Filed with authorized/valid electronic signature
MYSTIC DENTAL GROUP, P.C. 401(K) PLAN 2018 060982835 2019-07-13 MYSTIC DENTAL GROUP, P.C. 33
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1996-06-01
Business code 621210
Sponsor’s telephone number 4012846155
Plan sponsor’s address 117 COW HILL ROAD, MYSTIC, CT, 06355

Signature of
Role Plan administrator
Date 2019-07-13
Name of individual signing TRACEY S WILSON
Valid signature Filed with authorized/valid electronic signature
MYSTIC DENTAL GROUP, P.C. 401(K) PLAN 2017 060982835 2018-06-12 MYSTIC DENTAL GROUP, P.C. 22
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1996-06-01
Business code 621210
Sponsor’s telephone number 4012846155
Plan sponsor’s address 117 COW HILL ROAD, MYSTIC, CT, 06355

Signature of
Role Plan administrator
Date 2018-06-12
Name of individual signing TRACEY S WILSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-12
Name of individual signing TRACEY S WILSON
Valid signature Filed with authorized/valid electronic signature
MYSTIC DENTAL GROUP, P.C. 401(K) PLAN 2016 060982835 2017-05-30 MYSTIC DENTAL GROUP, P.C. 26
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1996-06-01
Business code 621210
Sponsor’s telephone number 8605364951
Plan sponsor’s address 117 COW HILL ROAD, MYSTIC, CT, 06355

Signature of
Role Plan administrator
Date 2017-05-30
Name of individual signing TRACEY S. WILSON
Valid signature Filed with authorized/valid electronic signature
MYSTIC DENTAL GROUP, P.C. 401(K) PLAN 2015 060982835 2016-07-11 MYSTIC DENTAL GROUP, P.C. 23
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1996-06-01
Business code 621210
Sponsor’s telephone number 8605364951
Plan sponsor’s address 117 COW HILL ROAD, MYSTIC, CT, 06355

Signature of
Role Plan administrator
Date 2016-07-11
Name of individual signing TRACEY S. WILSON
Valid signature Filed with authorized/valid electronic signature
MYSTIC DENTAL GROUP, P.C. 401(K) PLAN 2014 060982835 2015-10-10 MYSTIC DENTAL GROUP, P.C. 30
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1996-06-01
Business code 621210
Sponsor’s telephone number 8605364951
Plan sponsor’s address 117 COW HILL ROAD, MYSTIC, CT, 06355

Signature of
Role Plan administrator
Date 2015-10-10
Name of individual signing TRACEY WILSON
Valid signature Filed with authorized/valid electronic signature
MYSTIC DENTAL GROUP, P.C. 401(K) PLAN 2014 069082835 2015-07-09 MYSTIC DENTAL GROUP, P.C. 30
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1996-06-01
Business code 621210
Sponsor’s telephone number 8605364951
Plan sponsor’s address 117 COW HILL ROAD, MYSTIC, CT, 06355

Signature of
Role Plan administrator
Date 2015-07-09
Name of individual signing TRACEY S WILSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-09
Name of individual signing TRACEY S WILSON
Valid signature Filed with authorized/valid electronic signature
MYSTIC DENTAL GROUP, P.C. 401(K) PLAN 2013 060982835 2014-09-11 MYSTIC DENTAL GROUP, P.C. 24
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1996-06-01
Business code 621210
Sponsor’s telephone number 8605364951
Plan sponsor’s address 117 COW HILL ROAD, MYSTIC, CT, 06355

Signature of
Role Plan administrator
Date 2014-09-11
Name of individual signing TRACEY WILSON
Valid signature Filed with authorized/valid electronic signature
MYSTIC DENTAL GROUP, P.C. 401(K) PLAN 2009 069082835 2010-10-05 MYSTIC DENTAL GROUP, P.C. 17
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1996-06-01
Business code 621210
Sponsor’s telephone number 8605364951
Plan sponsor’s address 117 COW HILL ROAD, MYSTIC, CT, 06355

Plan administrator’s name and address
Administrator’s EIN 069082835
Plan administrator’s name MYSTIC DENTAL GROUP, P.C.
Plan administrator’s address 117 COW HILL ROAD, MYSTIC, CT, 06355
Administrator’s telephone number 8605364951

Signature of
Role Plan administrator
Date 2010-10-05
Name of individual signing MARK FALLON
Valid signature Filed with authorized/valid electronic signature

Officer

Name Role Business address Residence address
CHRISTOPHER M. WEST Officer 117 COW HILL ROAD, MYSTIC, CT, 06355, United States 12 Valley Drive, CONNECTICUT, Westerly, RI, 02891, United States
JOSEPH E. KUZMIC Officer 117 COW HILL ROAD, MYSTIC, CT, 06355, United States 12 STATE STREET, WESTERLY, RI, 02891, United States

Agent

Name Role
CONWAY, LONDREGAN, SHEEHAN & MONACO, P.C. Agent

History

Type Old value New value Date of change
Name change DRS. RICHARTZ, STEINBERG, MORRIS AND SMYLE, P.C. MYSTIC DENTAL GROUP, P.C. 1981-07-27

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012049212 2024-06-11 No data Annual Report Annual Report No data
BF-0011082275 2023-06-05 No data Annual Report Annual Report No data
BF-0010231014 2022-07-01 No data Annual Report Annual Report 2022
BF-0009758639 2021-07-05 No data Annual Report Annual Report No data
0006956703 2020-08-03 No data Annual Report Annual Report 2020
0006711721 2020-01-03 2020-01-03 Interim Notice Interim Notice No data
0006711724 2020-01-03 2020-01-03 Change of Agent Agent Change No data
0006596405 2019-07-13 No data Annual Report Annual Report 2019
0006202059 2018-06-18 No data Annual Report Annual Report 2018
0005897158 2017-07-28 No data Annual Report Annual Report 2017

Related by officers

CHRISTOPHER M. WEST

MYSTIC MEDICAL ARTS CENTER, LLC

Related by address

No related companies by address

Date of last update: 11 Nov 2024

Sources: Connecticut's Official State Website

Privacy policy Policy
About us About us
Contacts Contact us

© 2024 connecticutcompanysearch.com