| LCA CASE NUMBER | I-200-21238-546941 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2021-08-26 |
| DECISION DATE | 2022-04-07 |
| ORIGINAL CERT DATE | 2021-09-03 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | General 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 | Maverick Family Dental, P.C. |
| TRADE NAME DBA | Dr. Dental of New England |
| EMPLOYER ADDRESS1 | 45 Maverick Square |
| EMPLOYER CITY | Boston |
| EMPLOYER STATE | MA |
| EMPLOYER POSTAL CODE | 02128 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16175673800 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Mitchell |
| EMPLOYER POC FIRST NAME | Terri |
| EMPLOYER POC JOB TITLE | HR Manager |
| EMPLOYER POC ADDRESS1 | 45 Maverick Sqaure |
| EMPLOYER POC CITY | Boston |
| EMPLOYER POC STATE | MA |
| EMPLOYER POC POSTAL CODE | 02128 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16175673800 |
| EMPLOYER POC EMAIL | Terrim@familydentalnewengland.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Tietjen |
| AGENT ATTORNEY FIRST NAME | Rhonda |
| AGENT ATTORNEY MIDDLE NAME | A |
| AGENT ATTORNEY ADDRESS1 | 50 CONGRESS STREET |
| AGENT ATTORNEY ADDRESS2 | SUITE 200 |
| AGENT ATTORNEY CITY | Boston |
| AGENT ATTORNEY STATE | MA |
| AGENT ATTORNEY POSTAL CODE | 02109 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16175425111 |
| AGENT ATTORNEY EMAIL ADDRESS | rt@rsstlawgroup.com |
| LAWFIRM NAME BUSINESS NAME | Ross Silverman Snyder Tietjen LLP |
| STATE OF HIGHEST COURT | MA |
| NAME OF HIGHEST STATE COURT | MA SUPREME JUDICIAL COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 200 E. Main St. |
| LCA CASE WORKLOC1 CITY | Stratford |
| WORKSITE COUNTY | FAIRFIELD |
| LCA CASE WORKLOC1 STATE | CT |
| WORKSITE POSTAL CODE | 06614 |
| LCA CASE WAGE RATE FROM | 142813 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 142813 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |