| LCA CASE NUMBER | I-200-21095-196730 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-05 |
| DECISION DATE | 2021-04-12 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-10-01 |
| END DATE | 2024-09-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Wisconsin Dental Group S.C. |
| TRADE NAME DBA | Forward Dental |
| EMPLOYER ADDRESS1 | N114 W18770 Clinton Drive |
| EMPLOYER CITY | Germantown |
| EMPLOYER STATE | WI |
| EMPLOYER POSTAL CODE | 53022 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14143572040 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Hoppe |
| EMPLOYER POC FIRST NAME | Anita |
| EMPLOYER POC JOB TITLE | Director of Operations |
| EMPLOYER POC ADDRESS 1 | N114 W18770 Clinton Drive |
| EMPLOYER POC CITY | Germantown |
| EMPLOYER POC STATE | WI |
| EMPLOYER POC POSTAL CODE | 53022 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14142182551 |
| EMPLOYER POC EMAIL | ahoppe@amdpi.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Hoyt |
| AGENT ATTORNEY FIRST NAME | Matthew |
| AGENT ATTORNEY MIDDLE NAME | Wayne |
| AGENT ATTORNEY ADDRESS1 | 200 Civic Center Drive |
| AGENT ATTORNEY ADDRESS2 | Suite 1200 |
| AGENT ATTORNEY CITY | Columbus |
| AGENT ATTORNEY STATE | OH |
| AGENT ATTORNEY POSTAL CODE | 43215 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16144622650 |
| AGENT ATTORNEY EMAIL ADDRESS | mhoyt@bakerlaw.com |
| LAWFIRM NAME BUSINESS NAME | Baker & Hostetler LLP |
|
| STATE OF HIGHEST COURT | OH |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 15100 W. Library Ln. |
| LCA CASE WORKLOC1 CITY | New Berlin |
| WORKSITE COUNTY | WAUKESHA |
| LCA CASE WORKLOC1 STATE | WI |
| WORKSITE POSTAL CODE | 53151 |
| LCA CASE WAGE RATE FROM | 65.01 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 65.01 |
| 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 |
