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  5. Crossroads Family Dentistry, P.C.

Crossroads Family Dentistry, P.C.

Company Details

Name: Crossroads Family Dentistry, P.C.
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Delinquent
Date of registration: 21 Jun 2005 (20 years ago)
Date dissolved: 01 Nov 2013
Entity Number: 20051240410
ZIP code: 80915
County: El Paso County
Place of Formation: COLORADO
Principal Address: 1079 Space Center Dr. Colorado Springs CO 80915 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CROSSROADS FAMILY DENTISTRY 401K PLAN 2012 203001823 2013-05-04 CROSSROADS FAMILY DENTISTRY 4
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 541990
Sponsor’s telephone number 7193935577
Plan sponsor’s address 15501 OPEN SKY WAY, COLORADO SPRINGS, CO, 80908

Signature of
Role Plan administrator
Date 2013-05-04
Name of individual signing DR. EVAN C TILLOTSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-04
Name of individual signing DR. EVAN TILLOTSON
Valid signature Filed with authorized/valid electronic signature
CROSSROADS FAMILY DENTISTRY 401K PLAN 2012 203001823 2013-09-09 CROSSROADS FAMILY DENTISTRY 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 541990
Sponsor’s telephone number 7193935577
Plan sponsor’s address 15501 OPEN SKY WAY, COLORADO SPRINGS, CO, 80908

Signature of
Role Plan administrator
Date 2013-09-09
Name of individual signing DR. EVAN C TILLOTSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-09
Name of individual signing EVAN TILLOTSON
Valid signature Filed with authorized/valid electronic signature
CROSSROADS FAMILY DENTISTRY 401K PLAN 2012 203001823 2013-07-18 CROSSROADS FAMILY DENTISTRY 4
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 541990
Sponsor’s telephone number 7193935577
Plan sponsor’s address 15501 OPEN SKY WAY, COLORADO SPRINGS, CO, 80908

Signature of
Role Plan administrator
Date 2013-05-04
Name of individual signing DR. EVAN C TILLOTSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-04
Name of individual signing DR. EVAN TILLOTSON
Valid signature Filed with authorized/valid electronic signature
CROSSROADS FAMILY DENTISTRY 401K PLAN 2011 203001823 2012-04-10 CROSSROADS FAMILY DENTISTRY 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 541990
Sponsor’s telephone number 7195963481
Plan sponsor’s address 1079 SPACE CENTER DRIVE, SUITE 100, COLORADO SPRINGS, CO, 80915

Plan administrator’s name and address
Administrator’s EIN 203001823
Plan administrator’s name CROSSROADS FAMILY DENTISTRY
Plan administrator’s address 1079 SPACE CENTER DRIVE, SUITE 100, COLORADO SPRINGS, CO, 80915
Administrator’s telephone number 7195963481

Signature of
Role Plan administrator
Date 2012-04-10
Name of individual signing DR. EVAN C TILLOTSON
Valid signature Filed with authorized/valid electronic signature
CROSSROADS FAMILY DENTISTRY 401K PLAN 2010 203001823 2011-06-13 CROSSROADS FAMILY DENTISTRY 2
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 541990
Sponsor’s telephone number 7195963481
Plan sponsor’s address 1079 SPACE CENTER DRIVE, SUITE 100, COLORADO SPRINGS, CO, 80915

Plan administrator’s name and address
Administrator’s EIN 203001823
Plan administrator’s name CROSSROADS FAMILY DENTISTRY
Plan administrator’s address 1079 SPACE CENTER DRIVE, SUITE 100, COLORADO SPRINGS, CO, 80915
Administrator’s telephone number 7195963481
CROSSROADS FAMILY DENTISTRY 401K PLAN 2010 203001823 2011-06-16 CROSSROADS FAMILY DENTISTRY 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 541990
Sponsor’s telephone number 7195963481
Plan sponsor’s address 1079 SPACE CENTER DRIVE, SUITE 100, COLORADO SPRINGS, CO, 80915

Plan administrator’s name and address
Administrator’s EIN 203001823
Plan administrator’s name CROSSROADS FAMILY DENTISTRY
Plan administrator’s address 1079 SPACE CENTER DRIVE, SUITE 100, COLORADO SPRINGS, CO, 80915
Administrator’s telephone number 7195963481

Signature of
Role Plan administrator
Date 2011-06-16
Name of individual signing DR. EVAN C TILLOTSON
Valid signature Filed with authorized/valid electronic signature
CROSSROADS FAMILY DENTISTRY 401K PLAN 2009 203001823 2010-07-21 CROSSROADS FAMILY DENTISTRY 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 541990
Sponsor’s telephone number 7193935577
Plan sponsor’s address 1711 N. MURRAY BLVD, COLORADO SPRINGS, CO, 80915

Plan administrator’s name and address
Administrator’s EIN 203001823
Plan administrator’s name CROSSROADS FAMILY DENTISTRY
Plan administrator’s address 1711 N. MURRAY BLVD, COLORADO SPRINGS, CO, 80915
Administrator’s telephone number 7193935577

Signature of
Role Plan administrator
Date 2010-07-20
Name of individual signing EVAN TILLOTSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-20
Name of individual signing EVAN TILLOTSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Robert French Agent 1079 Space Center Colorado Springs CO 80915 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20121550661 Statement of Change Changing the Principal Office Address 2012-10-01 2012-10-01 No data Principal address changed;
20121550427 Statement of Change Changing the Registered Agent Information 2012-10-01 2012-10-01 No data Registered agent information changed;
20121485444 File Report 2012-09-01 2012-09-01 No data No data
20111437203 File Report 2011-08-01 2011-08-01 No data No data
20101584743 File Report 2010-10-25 2010-10-25 No data Change of Registered Agent Address
20101448690 Statement of Change Changing the Principal Office Address 2010-08-10 2010-08-10 No data Principal address changed;
20091415820 File Report 2009-08-03 2009-08-03 No data Change of Registered Agent
20081394106 File Report 2008-07-24 2008-07-24 No data No data
20071276393 File Report 2007-06-13 2007-06-13 No data No data
20061343721 File Report 2006-08-21 2006-08-21 No data Change of Registered Agent Address

Related by officers

Robert French

Robert French DMD PC Palmer Divide Photography LLC

Related by address

No related companies by address

Date of last update: 27 Jan 2025

Sources: Colorado's Secretary of State

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