PEDIATRIC DENTAL CENTER OF AVON, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-10-01
Business code	621210
Sponsor’s telephone number	8606748417
Plan sponsor’s address	44 DALE ROAD STE 305, AVON, CT, 06001

Signature of

Role	Plan administrator
Date	2024-07-10
Name of individual signing	CHRIS COSGROVE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-10-01
Business code	621210
Sponsor’s telephone number	8606748417
Plan sponsor’s address	44 DALE ROAD STE 305, AVON, CT, 06001

Signature of

Role	Plan administrator
Date	2023-07-05
Name of individual signing	CHRIS COSGROVE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-10-01
Business code	621210
Sponsor’s telephone number	8606748417
Plan sponsor’s address	44 DALE ROAD STE 305, AVON, CT, 06001

Signature of

Role	Plan administrator
Date	2022-06-27
Name of individual signing	CHRIS COSGROVE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-10-01
Business code	621210
Sponsor’s telephone number	8606748417
Plan sponsor’s address	44 DALE ROAD STE 305, AVON, CT, 06001

Signature of

Role	Plan administrator
Date	2021-06-30
Name of individual signing	CHRIS COSGROVE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-10-01
Business code	621210
Sponsor’s telephone number	8606748417
Plan sponsor’s address	44 DALE ROAD STE 305, AVON, CT, 06001

Signature of

Role	Plan administrator
Date	2020-07-10
Name of individual signing	CHRIS COSGROVE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-10-01
Business code	621210
Sponsor’s telephone number	8606748417
Plan sponsor’s address	44 DALE ROAD STE 305, AVON, CT, 06001

Signature of

Role	Plan administrator
Date	2019-07-19
Name of individual signing	CHRIS COSGROVE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-10-01
Business code	621210
Sponsor’s telephone number	8606748417
Plan sponsor’s address	44 DALE ROAD, SUITE 305, AVON, CT, 06001

Signature of

Role	Plan administrator
Date	2018-02-21
Name of individual signing	JEANMARIE COSGROVE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-10-01
Business code	621210
Sponsor’s telephone number	8606748417
Plan sponsor’s address	44 DALE ROAD, SUITE 305, AVON, CT, 06001

Signature of

Role	Plan administrator
Date	2017-04-20
Name of individual signing	JEANMARIE COSGROVE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-10-01
Business code	621210
Sponsor’s telephone number	8606748417
Plan sponsor’s address	44 DALE ROAD, SUITE 305, AVON, CT, 06001

Signature of

Role	Plan administrator
Date	2016-07-18
Name of individual signing	JEANMARIE COSGROVE
Valid signature	Filed with authorized/valid electronic signature