| LCA CASE NUMBER | I-200-21175-424975 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-06-24 |
| DECISION DATE | 2021-07-01 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | General Dentist |
| SOC CODE | 29-1029.00 |
| SOC TITLE | Dentists, All Other Specialists |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-13 |
| END DATE | 2024-07-12 |
| 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 | Rural Health Corporation of Northeastern PA |
| EMPLOYER ADDRESS1 | 1084 PA-315 |
| EMPLOYER CITY | Wilkes-Barre |
| EMPLOYER STATE | PA |
| EMPLOYER POSTAL CODE | 18702 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 15708258741 |
| NAICS CODE | 62121 |
| EMPLOYER POC LAST NAME | Tankalavage |
| EMPLOYER POC FIRST NAME | Tiffany |
| EMPLOYER POC MIDDLE NAME | L |
| EMPLOYER POC JOB TITLE | President & CEO |
| EMPLOYER POC ADDRESS1 | 1084 PA-315 |
| EMPLOYER POC CITY | Wilkes-Barre |
| EMPLOYER POC STATE | PA |
| EMPLOYER POC POSTAL CODE | 18702 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 15708258741 |
| EMPLOYER POC EMAIL | ttankalavage@rhc1084.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Castrodale |
| AGENT ATTORNEY FIRST NAME | Alexander |
| AGENT ATTORNEY MIDDLE NAME | R |
| AGENT ATTORNEY ADDRESS1 | 625 Liberty Ave |
| AGENT ATTORNEY ADDRESS2 | Floor 5 |
| AGENT ATTORNEY CITY | Pittsburgh |
| AGENT ATTORNEY STATE | PA |
| AGENT ATTORNEY POSTAL CODE | 15222 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14122974712 |
| AGENT ATTORNEY EMAIL ADDRESS | adam.teets@dentons.com |
| LAWFIRM NAME BUSINESS NAME | Dentons Cohen & Grigsby P.C. |
|
| STATE OF HIGHEST COURT | PA |
| NAME OF HIGHEST STATE COURT | Pennsylvania Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 404 Ridge St. |
| LCA CASE WORKLOC1 CITY | Freeland |
| WORKSITE COUNTY | LUZERNE |
| LCA CASE WORKLOC1 STATE | PA |
| WORKSITE POSTAL CODE | 18224 |
| LCA CASE WAGE RATE FROM | 135000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 113506 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H-1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Castrodale |
| PREPARER FIRST NAME | Alexander |
| PREPARER BUSINESS NAME | Dentons Cohen and Grigsby PC |
| PREPARER EMAIL | adam.teets@dentons.com |
