| Company Name: | PRIME CARE DENTAL PLAN |
| Employer identification number (EIN): | 680465645 |
| National Association of Insurance Commissioner's ID: | 00000 |
| NAIC Classification: | 00000 |
| BOARD OF TRUSTEES LABORERS HEALTH | LABORERS HEALTH AND WELFARE TRUST FUND FOR NORTHERN CALIFORNIA | 2015-06-01 |