| LCA CASE NUMBER | I-200-21095-198766 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-05 |
| DECISION DATE | 2021-04-12 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Dentist |
| SOC CODE | 29-1029.00 |
| SOC TITLE | Dentists, All Other Specialists |
| 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 | Captain Smiles of Greeley PC |
| TRADE NAME DBA | Adventure Dental, Vision and Orthodontics |
| EMPLOYER ADDRESS1 | 2221 E. Bijou Street |
| EMPLOYER ADDRESS2 | Suite 100 |
| EMPLOYER CITY | Colorado Springs |
| EMPLOYER STATE | CO |
| EMPLOYER POSTAL CODE | 80909 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17196667331 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Lee |
| EMPLOYER POC FIRST NAME | Jamie |
| EMPLOYER POC JOB TITLE | Provider Relations Coordinator |
| EMPLOYER POC ADDRESS 1 | 2221 E. Bijou St. |
| EMPLOYER POC ADDRESS 2 | Ste 100 |
| EMPLOYER POC CITY | Colorado Springs |
| EMPLOYER POC STATE | CO |
| EMPLOYER POC POSTAL CODE | 80909 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17196667331 |
| EMPLOYER POC PHONE EXT | 3138 |
| EMPLOYER POC EMAIL | jamie.lee@herodvo.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Schultz |
| AGENT ATTORNEY FIRST NAME | Jonathan |
| AGENT ATTORNEY ADDRESS1 | 8601 N. Scottsdale Rd |
| AGENT ATTORNEY ADDRESS2 | Suite 300 |
| AGENT ATTORNEY CITY | Scottsdale |
| AGENT ATTORNEY STATE | AZ |
| AGENT ATTORNEY POSTAL CODE | 85253 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14804295000 |
| AGENT ATTORNEY EMAIL ADDRESS | jon.schultz@kutakrock.com |
| LAWFIRM NAME BUSINESS NAME | Kutak Rock LLP |
| STATE OF HIGHEST COURT | AZ |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 3485 West 10th Street |
| WORKSITE ADDRESS2 | Suite C |
| LCA CASE WORKLOC1 CITY | Greeley |
| WORKSITE COUNTY | WELD |
| LCA CASE WORKLOC1 STATE | CO |
| WORKSITE POSTAL CODE | 80634 |
| LCA CASE WAGE RATE FROM | 221000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 85842 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| 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 |
