| LCA CASE NUMBER | I-200-21008-003680 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-01-08 |
| DECISION DATE | 2021-01-15 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | General Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | False |
| LCA CASE EMPLOYMENT START DATE | 2021-01-18 |
| END DATE | 2024-01-17 |
| 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 | Park Dental |
| EMPLOYER ADDRESS1 | 2200 County Road C-West |
| EMPLOYER CITY | Roseville |
| EMPLOYER STATE | MN |
| EMPLOYER POSTAL CODE | 55113 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16517462825 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Fisher |
| EMPLOYER POC FIRST NAME | Kimberly |
| EMPLOYER POC JOB TITLE | Clinical Support Manager |
| EMPLOYER POC ADDRESS 1 | 2200 County Road C-West |
| EMPLOYER POC CITY | Roseville |
| EMPLOYER POC STATE | MN |
| EMPLOYER POC POSTAL CODE | 55113 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16517462825 |
| EMPLOYER POC EMAIL | kfisher@parkdental.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Mojica |
| AGENT ATTORNEY FIRST NAME | Jenny |
| AGENT ATTORNEY MIDDLE NAME | Bouta |
| AGENT ATTORNEY ADDRESS1 | 200 South Sixth Street |
| AGENT ATTORNEY ADDRESS2 | Suite 4000 |
| AGENT ATTORNEY CITY | Minneapolis |
| AGENT ATTORNEY STATE | MN |
| AGENT ATTORNEY POSTAL CODE | 55402 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16124927100 |
| AGENT ATTORNEY EMAIL ADDRESS | jmojica@fredlaw.com |
| LAWFIRM NAME BUSINESS NAME | Fredrikson & Byron PA |
| STATE OF HIGHEST COURT | MN |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 8559 Edinbrook Pkwy |
| LCA CASE WORKLOC1 CITY | Brooklyn Park |
| WORKSITE COUNTY | HENNEPIN |
| LCA CASE WORKLOC1 STATE | MN |
| WORKSITE POSTAL CODE | 55443 |
| LCA CASE WAGE RATE FROM | 88.85 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 63.97 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
