KEITH A. BLALOCK, D.D.S., M.S., P.C. PROFIT SHARING PLAN 401k Plan overview

KEITH A. BLALOCK, D.D.S., M.S., P.C. PROFIT SHARING PLAN Benefits

401k Sponsoring company profile

Company Name:	KEITH A. BLALOCK, D.D.S., M.S., P.C.
Employer identification number (EIN):	742938794
NAIC Classification:	621210
NAIC Description:	Offices of Dentists

Form 5500 Filing Information

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01
001	2012-01-01	LAURIEN SALESBERRY	2013-01-24
001	2011-01-01	KEITH BLALOCK	2012-01-30
001	2010-01-01	KEITH BLALOCK	2011-02-08

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