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  5. BLUE BACK DENTAL, LLC

BLUE BACK DENTAL, LLC

Date of last update: 21 Apr 2025. Data updated weekly.

Companies that start with "BLUE"

Company Details

Entity Name: BLUE BACK DENTAL, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 21 Mar 2011
Business ALEI: 1032262
Annual report due: 31 Mar 2026
Business address: 65 MEMORIAL DRIVE SUITE 400, WEST HARTFORD, CT, 06107, United States
Mailing address: 65 MEMORIAL DRIVE - SUITE 400, WEST HARTFORD, CT, United States, 06107
ZIP code: 06107
County: Hartford
Place of Formation: CONNECTICUT
E-Mail: kelsey@bluebackdental.com

Industry & Business Activity

NAICS

621210 Offices of Dentists

This industry comprises establishments of health practitioners having the degree of D.M.D. (Doctor of Dental Medicine), D.D.S. (Doctor of Dental Surgery), or D.D.Sc. (Doctor of Dental Science) primarily engaged in the independent practice of general or specialized dentistry or dental surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. They can provide either comprehensive preventive, cosmetic, or emergency care, or specialize in a single field of dentistry. Learn more at the U.S. Census Bureau

Companies doing Offices of dentists

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLUE BACK DENTAL, LLC 401(K) PROFIT SHARING TRUST 2023 451623829 2024-05-21 BLUE BACK DENTAL, LLC 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 8602339300
Plan sponsor’s address 65 MEMORIAL ROAD, SUITE 400, WEST HARTFORD, CT, 06107

Signature of
Role Plan administrator
Date 2024-05-21
Name of individual signing THEODORE WU
Valid signature Filed with authorized/valid electronic signature
BLUE BACK DENTAL, LLC 401(K) PROFIT SHARING TRUST 2022 451623829 2023-08-23 BLUE BACK DENTAL, LLC 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 8602339300
Plan sponsor’s address 65 MEMORIAL ROAD, SUITE 400, WEST HARTFORD, CT, 06107

Signature of
Role Plan administrator
Date 2023-08-23
Name of individual signing THEODORE WU
Valid signature Filed with authorized/valid electronic signature
BLUE BACK DENTAL, LLC 401(K) PROFIT SHARING TRUST 2021 451623829 2022-04-27 BLUE BACK DENTAL, LLC 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 8602339300
Plan sponsor’s address 65 MEMORIAL ROAD, SUITE 400, WEST HARTFORD, CT, 06107

Signature of
Role Plan administrator
Date 2022-04-27
Name of individual signing THEODORE WU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-04-27
Name of individual signing THEODORE WU
Valid signature Filed with authorized/valid electronic signature
BLUE BACK DENTAL, LLC 401(K) PROFIT SHARING TRUST 2020 451623829 2021-07-27 BLUE BACK DENTAL, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 8602339300
Plan sponsor’s address 65 MEMORIAL ROAD, SUITE 400, WEST HARTFORD, CT, 06107

Signature of
Role Plan administrator
Date 2021-07-27
Name of individual signing THEODORE WU
Valid signature Filed with authorized/valid electronic signature
BLUE BACK DENTAL, LLC 401(K) PROFIT SHARING TRUST 2019 451623829 2020-06-30 BLUE BACK DENTAL, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 8602339300
Plan sponsor’s address 65 MEMORIAL ROAD, SUITE 400, WEST HARTFORD, CT, 06107

Signature of
Role Plan administrator
Date 2020-06-30
Name of individual signing THEODORE WU
Valid signature Filed with authorized/valid electronic signature
BLUE BACK DENTAL, LLC 401(K) PROFIT SHARING PLAN 2018 451623829 2019-06-12 BLUE BACK DENTAL, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 8602339300
Plan sponsor’s address 65 MEMORIAL ROAD, SUITE 400, WEST HARTFORD, CT, 06107

Signature of
Role Plan administrator
Date 2019-06-12
Name of individual signing TED WU
Valid signature Filed with authorized/valid electronic signature
BLUE BACK DENTAL, LLC 401(K) PROFIT SHARING PLAN 2017 451623829 2018-07-02 BLUE BACK DENTAL, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 8602339300
Plan sponsor’s address 65 MEMORIAL ROAD, SUITE 400, WEST HARTFORD, CT, 06107

Signature of
Role Plan administrator
Date 2018-07-02
Name of individual signing TED WU
Valid signature Filed with authorized/valid electronic signature
BLUE BACK DENTAL, LLC 401(K) PROFIT SHARING PLAN 2016 451623829 2017-05-31 BLUE BACK DENTAL, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 8602339300
Plan sponsor’s address 65 MEMORIAL ROAD, SUITE 400, WEST HARTFORD, CT, 06107

Signature of
Role Plan administrator
Date 2017-05-31
Name of individual signing TED WU
Valid signature Filed with authorized/valid electronic signature
BLUE BACK DENTAL, LLC 401(K) PROFIT SHARING PLAN 2015 451623829 2016-07-01 BLUE BACK DENTAL, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 8602339300
Plan sponsor’s address 65 MEMORIAL ROAD, SUITE 400, WEST HARTFORD, CT, 06107

Signature of
Role Plan administrator
Date 2016-07-01
Name of individual signing TED WU
Valid signature Filed with authorized/valid electronic signature
BLUE BACK DENTAL, LLC 401(K) PROFIT SHARING PLAN 2014 451623829 2015-05-12 BLUE BACK DENTAL, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 8602339300
Plan sponsor’s address 65 MEMORIAL ROAD, SUITE 400, WEST HARTFORD, CT, 06107

Signature of
Role Plan administrator
Date 2015-05-12
Name of individual signing KIRSTEN ZETTERGREN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-05-12
Name of individual signing KIRSTEN ZETTERGREN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
SCOTT B FRANKLIN Agent 68 SOUTH MAIN ST, WEST HARTFORD, CT, 06107, United States 68 SOUTH MAIN ST, WEST HARTFORD, CT, 06107, United States +1 860-798-0901 kelsey@bluebackdental.com BURR STREET, WEST HARTFORD, CT, 06107, United States

Officer

Name Role Business address Residence address
TIMOTHY R. HOLZHAUER DMD Officer 65 MEMORIAL DRIVE, SUITE 400, WEST HARTFORD, CT, 06107, United States 2 KENSINGTON PLACE, FARMINGTON, CT, 06032, United States
ELIZABETH D. HOLZHAUER DMD Officer 65 MEMORIAL DRIVE, SUITE 400, WEST HARTFORD, CT, 06107, United States 2 KENSINGTON PLACE, FARMINGTON, CT, 06032, United States
THEODORE WU D.M.D. Officer 65 MEMORIAL DR, STE. 400, WEST HARTFORD, CT, 06107, United States 35 HASTINGS TURN, AVON, CT, 06001, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0013007237 2025-03-03 - Annual Report Annual Report -
BF-0012144056 2024-04-16 - Annual Report Annual Report -
BF-0011188596 2023-02-01 - Annual Report Annual Report -
BF-0008961712 2022-12-20 - Annual Report Annual Report 2020
BF-0010747422 2022-12-20 - Annual Report Annual Report -
BF-0009901844 2022-12-20 - Annual Report Annual Report -
0006383292 2019-02-14 - Annual Report Annual Report 2019
0006108530 2018-03-06 - Annual Report Annual Report 2018
0006084888 2018-02-19 - Annual Report Annual Report 2017
0005784065 2017-03-06 - Annual Report Annual Report 2015

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
2818737105 2020-04-11 0156 PPP 65 MEMORIAL RD STE 400, WEST HARTFORD, CT, 06107-2200
Loan Status Date 2021-08-24
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 273705
Loan Approval Amount (current) 273705
Undisbursed Amount 0
Franchise Name -
Lender Location ID 29805
Servicing Lender Name TD Bank, National Association
Servicing Lender Address 2035 Limestone Rd, WILMINGTON, DE, 19808-5529
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address WEST HARTFORD, HARTFORD, CT, 06107-2200
Project Congressional District CT-01
Number of Employees 22
NAICS code 621210
Borrower Race Asian
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 29805
Originating Lender Name TD Bank, National Association
Originating Lender Address WILMINGTON, DE
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 276997.06
Forgiveness Paid Date 2021-06-30
8763378404 2021-02-13 0156 PPS 65 Memorial Rd Ste 400, West Hartford, CT, 06107-4219
Loan Status Date 2021-11-23
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 300000
Loan Approval Amount (current) 300000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 29805
Servicing Lender Name TD Bank, National Association
Servicing Lender Address 2035 Limestone Rd, WILMINGTON, DE, 19808-5529
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address West Hartford, HARTFORD, CT, 06107-4219
Project Congressional District CT-01
Number of Employees 25
NAICS code 621210
Borrower Race Asian
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 29805
Originating Lender Name TD Bank, National Association
Originating Lender Address WILMINGTON, DE
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 301900
Forgiveness Paid Date 2021-10-06

Debts and Liens

This table presents a concise summary of a company's liens and debts, detailing essential information such as the lien type, debt amount, associated parties, and current status of each financial obligation.

Subsequent Filing No Status Type Filing Date Lapse Date Filing Type
0005269083 Active OFS 2025-02-14 2030-07-22 AMENDMENT

Parties
Name BLUE BACK DENTAL, LLC
Role Debtor
Name TD BANK, N.A.
Role Secured Party
0005263999 Active OFS 2025-01-22 2030-06-04 AMENDMENT

Parties
Name BLUE BACK DENTAL, LLC
Role Debtor
Name TD BANK, NATIONAL ASSOCIATION
Role Secured Party
0005115182 Active OFS 2023-01-17 2030-06-04 AMENDMENT

Parties
Name BLUE BACK DENTAL, LLC
Role Debtor
Name TD BANK, NATIONAL ASSOCIATION
Role Secured Party
0005105447 Active OFS 2022-11-18 2027-11-18 ORIG FIN STMT

Parties
Name BLUE BACK DENTAL, LLC
Role Debtor
Name McKesson Corporation, for itself and as collateral agent for each of its affiliates
Role Secured Party
0003375149 Active OFS 2020-06-04 2030-06-04 ORIG FIN STMT

Parties
Name BLUE BACK DENTAL, LLC
Role Debtor
Name TD BANK, NATIONAL ASSOCIATION
Role Secured Party
0003353191 Active OFS 2020-02-05 2030-07-22 AMENDMENT

Parties
Name BLUE BACK DENTAL, LLC
Role Debtor
Name TD BANK, N.A.
Role Secured Party
0003067952 Active OFS 2015-07-22 2030-07-22 ORIG FIN STMT

Parties
Name BLUE BACK DENTAL, LLC
Role Debtor
Name TD BANK, N.A.
Role Secured Party

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See something incorrect or outdated? Let us know

Sources: Company Profile on Connecticut's Official State Website

* While we strive to keep this information correct and up-to-date, it is not the primary source, and the dataset source should always be referred to for definitive information

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