DENTAL GROUP OF MERIDEN-WALLINGFORD, PC

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2022-01-01
Business code	621210
Sponsor’s telephone number	2032355588
Plan sponsor’s address	298 BROAD STREET, MERIDEN, CT, 06450

Signature of

Role	Plan administrator
Date	2024-09-24
Name of individual signing	KAREN KOWALSKI
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2022-01-01
Business code	621210
Sponsor’s telephone number	2032355588
Plan sponsor’s address	298 BROAD STREET, MERIDEN, CT, 06450

Signature of

Role	Plan administrator
Date	2023-09-28
Name of individual signing	KAREN KOWALSKI
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1990-04-11
Business code	621210
Sponsor’s telephone number	2032722417
Plan sponsor’s address	7 GOLDENROD CT, CHESHIRE, CT, 064103323

Plan administrator’s name and address

Administrator’s EIN	061289762
Plan administrator’s name	DENTAL GROUP OF MERIDEN-WALLINGFORD
Plan administrator’s address	7 GOLDENROD CT, CHESHIRE, CT, 064103323
Administrator’s telephone number	2032722417

Signature of

Role	Plan administrator
Date	2011-10-17
Name of individual signing	SUSAN MATLOFF
Valid signature	Filed with authorized/valid electronic signature