| Name: | Gray Family Dentistry, PSC |
| Jurisdiction: | Kentucky |
| Profit or Non-Profit: | Profit |
| Legal type: | Kentucky Professional Services Corp |
| Status: | Active |
| Standing: | Good |
| File Date: | 21 Jan 2016 (9 years ago) |
| Organization Date: | 21 Jan 2016 (9 years ago) |
| Organization Number: | 0942210 |
| Industry: | Health Services |
| Number of Employees: | Small (0-19) |
| Primary County: | Jefferson |
| Place of Formation: | KENTUCKY |
| Last Annual Report: | 21 Mar 2024 (8 months ago) |
| Principal Office: | 125 CHENOWETH LN, STE. 204, LOUISVILLE, KY 40207 |
| Principal Office ZIP code: | 40207 |
| Authorized Shares: | 1000 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GRAY FAMILY DENTISTRY PSC CBS BENEFIT PLAN | 2022 | 811367034 | 2023-12-27 | GRAY FAMILY DENTISTRY PSC | 2 | |||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 846429706 |
| Plan administrator’s name | SHAWNA BURTON |
| Plan administrator’s address | 464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number | 5026954700 |
Signature of
| Role | Plan administrator |
| Date | 2023-12-27 |
| Name of individual signing | SHAWNA BURTON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 501 |
| Effective date of plan | 2021-10-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 5028975454 |
| Plan sponsor’s address | 125 CHENOWETH LN, STE 204, LOUISVILLE, KY, 40207 |
Plan administrator’s name and address
| Administrator’s EIN | 846429706 |
| Plan administrator’s name | SHAWNA BURTON |
| Plan administrator’s address | 464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number | 5026954700 |
Signature of
| Role | Plan administrator |
| Date | 2022-12-29 |
| Name of individual signing | SHAWNA BURTON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| NOWELL GRAY | Registered Agent |
| Nowell Gray | Registered Agent |
| Name | Role |
|---|---|
| Nowell Evan Gray | President |
| Name | Role |
|---|---|
| Nowell Evan Gray | Shareholder |
| Nowell Gray | Shareholder |
| Name | Role |
|---|---|
| Nowell Gray | Incorporator |
| Name | File Date |
|---|---|
| Annual Report | 2024-03-21 |
| Annual Report | 2023-05-30 |
| Annual Report | 2022-08-08 |
| Annual Report | 2021-02-11 |
| Annual Report | 2020-06-01 |
| Annual Report | 2019-05-29 |
| Annual Report | 2018-06-01 |
| Registered Agent name/address change | 2017-06-19 |
| Annual Report | 2017-06-19 |
| Principal Office Address Change | 2017-04-27 |
Date of last update: 18 Nov 2024
Sources: Kentucky Secretary of State
