| LCA CASE NUMBER | I-200-21201-472261 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2021-07-20 |
| DECISION DATE | 2022-10-31 |
| ORIGINAL CERT DATE | 2021-07-27 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Associate Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-26 |
| END DATE | 2023-07-19 |
| 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 | Union Street Dental, PLC |
| TRADE NAME DBA | Union Street Dental |
| EMPLOYER ADDRESS1 | 130 Union Street |
| EMPLOYER ADDRESS2 | Unit 1 |
| EMPLOYER CITY | Bennington |
| EMPLOYER STATE | VT |
| EMPLOYER POSTAL CODE | 05201 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18024477682 |
| NAICS CODE | 62121 |
| EMPLOYER POC LAST NAME | Keel |
| EMPLOYER POC FIRST NAME | Michael |
| EMPLOYER POC MIDDLE NAME | Wade |
| EMPLOYER POC JOB TITLE | Regional OPS Manager |
| EMPLOYER POC ADDRESS1 | 2 Solar Way |
| EMPLOYER POC ADDRESS2 | 103 |
| EMPLOYER POC CITY | Latham |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 12110 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 15188107305 |
| EMPLOYER POC EMAIL | mikekeel@vtdentalagency.com |
| AGENT REPRESENTING EMPLOYER | False |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 130 Union Street |
| WORKSITE ADDRESS2 | Unit 1 |
| LCA CASE WORKLOC1 CITY | Bennington |
| WORKSITE COUNTY | BENNINGTON |
| LCA CASE WORKLOC1 STATE | VT |
| WORKSITE POSTAL CODE | 05201 |
|
| LCA CASE WAGE RATE FROM | 10061.6 |
| LCA CASE WAGE RATE TO | 15000 |
| LCA CASE WAGE RATE UNIT | Bi-Weekly |
| PREVAILING WAGE | 125.77 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H 1B DEPENDENT | True |
| WILLFUL VIOLATOR | False |
| SUPPORT H1B | True |
| STATUTORY BASIS | Masters Degree or higher in related specialty |
| APPENDIX A ATTACHED | True |
| PUBLIC DISCLOSURE | Disclose Employment |
