| LCA CASE NUMBER | I-200-20223-760255 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-08-10 |
| DECISION DATE | 2020-08-17 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | General Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-08-17 |
| END DATE | 2023-08-16 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Network Provider Associates, P.C. |
| TRADE NAME DBA | Stillwater Dental Care |
| EMPLOYER ADDRESS1 | 5619 W. Loop 1604 North |
| EMPLOYER ADDRESS2 | Suite 112 |
| EMPLOYER CITY | San Antonio |
| EMPLOYER STATE | TX |
| EMPLOYER POSTAL CODE | 78253 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 12105380960 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Yu |
| EMPLOYER POC FIRST NAME | Victoria |
| EMPLOYER POC JOB TITLE | Chief Clinical Officer |
| EMPLOYER POC ADDRESS1 | 5619 W. Loop 1604 North |
| EMPLOYER POC ADDRESS2 | Suite 112 |
| EMPLOYER POC CITY | San Antonio |
| EMPLOYER POC STATE | TX |
| EMPLOYER POC POSTAL CODE | 78253 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 12105380960 |
| EMPLOYER POC EMAIL | vyu@mid-atlanticdental.com |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Coenen |
| AGENT ATTORNEY FIRST NAME | Nicholas |
| AGENT ATTORNEY MIDDLE NAME | J |
| AGENT ATTORNEY ADDRESS1 | 332 S. Michigan Ave. |
| AGENT ATTORNEY ADDRESS2 | Suite 1428 |
| AGENT ATTORNEY CITY | Chicago |
| AGENT ATTORNEY STATE | IL |
| AGENT ATTORNEY POSTAL CODE | 60604 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 13123419730.0 |
| AGENT ATTORNEY EMAIL ADDRESS | nicholasjc@klc-ltd.com |
| LAWFIRM NAME BUSINESS NAME | Kempster, Corcoran, Quiceno, & Lenz-Calvo LTD |
| STATE OF HIGHEST COURT | IL |
| NAME OF HIGHEST STATE COURT | Illinois Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 5619 W. Loop 1604 North |
| WORKSITE ADDRESS2 | Suite 112 |
| LCA CASE WORKLOC1 CITY | San Antonio |
| WORKSITE COUNTY | BEXAR |
| LCA CASE WORKLOC1 STATE | TX |
| WORKSITE POSTAL CODE | 78253 |
| LCA CASE WAGE RATE FROM | 97032.0 |
| LCA CASE WAGE RATE TO | 155000.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 97032.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
