2022-11-02T14:29:29-05:00 2021-12-31 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2021-01-01 860274899 ARIZONA DENTAL INSURANCE SERVICE INC ARIZ 6025883976 5656 WEST TALAVI BLVD GLENDALE AZ 85306 MARK ANDERSON CFO/VICE PRESIDENT 6029383131 2022-10-25 1 MARK ANDERSON 999009999 DAVID LOWENTHAL P00378651 3122071040 2022-10-25 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z DELTA DENTAL OF ARIZONA MARK ANDERSON 5656 WEST TALAVI BLVD GLENDALE AZ 85306 189286451 0 X WWW.DELTADENTALAZ.COM X 1972 AZ THE CORPORATION EXISTS TO IMPROVE LIVES BY PROMOTING OPTIMAL ORAL HEALTH. 11 7 131 0 105906 9967 0 0 107428361 141725720 3596566 8412032 5622 115504 111030549 150253256 429516 380195 0 0 13933750 15970973 0 0 0 88225869 122919065 102589135 139270233 8441414 10983023 129697627 142905114 16064162 16625830 113633465 126279284 THE CORPORATION EXISTS TO IMPROVE LIVES BY PROMOTING OPTIMAL ORAL HEALTH. 0 0 120931273 141841224 THE ORGANIZATION PROVIDED DENTAL BENEFIT COVERAGE FOR 408,655 BENEFICIARIES INCLUDED AMONG THESE BENEFICIARIES WERE I) 29,652 INDIVIDUAL ENROLLEES, MANY OF WHOM ARE HIGH-RISK INDIVIDUALS WHO MAY NOT OTHERWISE RECEIVE ACCESS TO AFFORDABLE DENTAL BENEFIT COVERAGE. THESE INDIVIDUALS OBTAINED COVERAGE AS A RESULT OF THE ORGANIZATION'S COLLABORATION WITH CHARITABLE AND GOVERNMENTAL ORGANIZATIONS; II) 48,451 ENROLLEES WHO ARE OR WERE EMPLOYED WITH THE STATE OF ARIZONA,; III) 54,073 ENROLLEES WHO ARE OR WERE EMPLOYED WITH THE ARIZONA STATE RETIREMENT SYSTEM, AND IV) THE ORGANIZATION EXPENDED MORE THAN $97 MILLION FOR DENTAL CARE DURING 2021, WITH DENTAL BENEFITS COVERAGE BEING PROVIDED THROUGH CONTRACTS WITH INDEPENDENT PROFESSIONAL DENTAL SERVICE PROVIDERS. 380195 380195 THE ORGANIZATION ALSO MAKES GRANTS AND DONATES FACILITIES, EQUIPMENT, AND EMPLOYEE TIME TO SUPPORT MANY CHARITABLE CAUSES. DURING 2021, THE ORGANIZATION PROVIDED OR SUPPORTED PREVENTATIVE DENTAL HEALTH SERVICES, CHILDREN'S ORAL HEALTH SERVICE, DENTAL CLINICS, IN-SCHOOL SCREENINGS, TOBACCO AND CHRONIC DISEASE PREVENTION PROGRAMS, EARLY CHILDHOOD PROGRAMS, PRENATAL AND POSTNATAL ORAL HEALTH, AND ACCESS TO DENTAL SERVICES. 121311468 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 18416 0 1 131 1 1 1 0 0 0 0 0 0 0 1 0 X 11 7 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 AZ X MARK ANDERSON 6029383131 5656 WEST TALAVI BLVD GLENDALE AZ 85306 RICHARD B HIGGS DDS BOARD CHAIR 10.00 0.00 X X 29333 0 0 CANDANCE HUNTER WIEST FORMER BOARD CHAIR 10.00 0.00 X X 26667 0 0 STEPHEN MEYER HOUGHTON SECRETARY/TREASURER 3.00 0.00 X X 24000 0 0 RONALD V DAVELLA VICE-CHAIRMAN 3.00 0.00 X X 24000 0 0 GARY OWEN JONES DDS BOARD MEMBER 3.00 0.00 X 24000 0 0 GERALD E LOE BOARD MEMBER 3.00 0.00 X 24000 0 0 BRUCE ALLAN SPIGNER DDS BOARD MEMBER 3.00 1.00 X 24000 0 0 MICHAEL A WARREN BOARD MEMBER 3.00 0.00 X 24000 0 0 BRENDA SCHMIDT BOARD MEMBER 3.00 0.00 X 22000 0 0 SHAHARYAR ASHRAF BOARD MEMBER 3.00 0.00 X 16000 0 0 MICHAEL ERICKSON BOARD MEMBER 3.00 0.00 X 16000 0 0 WILLIAM LUND PUTNAM BOARD MEMBER (THRU 4/21) 3.00 0.00 X 16000 0 0 ALVIN CHARLES MATTHEWS BOARD MEMBER (THRU 4/21) 3.00 0.00 X 8000 0 0 JUSTIN MICHAEL BAYLESS BOARD MEMBER (THRU 1/21) 3.00 0.00 X 2000 0 0 ALLAN ALLFORD PRESIDENT/CEO (THRU 12/21) 40.00 2.00 X 1144928 0 206090 BRAD CLOTHIER SENIOR VICE PRESIDENT 40.00 0.00 X 625708 0 124053 MARK ANDERSON VICE PRESIDENT/CFO 40.00 0.00 X 579870 0 117769 CRAIG LIVESAY VICE PRESIDENT/COO 40.00 0.00 X 493783 0 92143 LESLIE HESS CHIEF COMPLIANCE OFFICER 40.00 0.00 X 412677 0 78270 MICHAEL JONES PRESIDENT/CEO (BEG 10/21) 40.00 0.00 X 428438 0 54518 SCOTT PEDERSON VICE PRESIDENT 40.00 0.00 X 322611 0 76404 JOLEAN FLECK VICE PRESIDENT, PEOPLE & ORG DEVELOP 40.00 0.00 X 265878 0 54285 HEATHER MOLLON SENIOR DIRECTOR OF CLIENT RELATIONSHIP 40.00 0.00 X 218018 0 19676 ERIC SKARTVEIT SENIOR DIRECTOR OF UNDERWRITING 40.00 0.00 X 212820 0 24613 JOHN BRULEY DIRECTOR OF IT 40.00 0.00 X 204241 0 29269 JOSHUA CUPERO DIRECTOR OF FINANCE 40.00 0.00 X 211276 0 9240 TIFFANY DI GIACINTO SENIOR DIRECTOR OF MARKETING 40.00 0.00 X 180830 0 19623 5581078 0 905953 31 0 1 0 NORTHWINDS TECHNOLOGY SOLUTION PO BOX 828 STEVENS POINT WI 54481 IT SERVICES 2005775 WEST MONROE PARTNERS 311 W MONROE STREET CHICAGO IL 60606 CONSULTING 1834045 WYSSTA SERVICES INC PO BOX 86 STEVENS POINT WI 54481 ADMINISTRATIVE SERVICES 1722772 DELTA DENTAL OF MICHIGAN 16082 COLLECTION CENTER DRIVE CHICAGO IL 60693 CLAIMS AND BILLING SERVICES 1559972 MODERN IMPACT LLC 100 S 5TH ST SUITE 1000 MINNEAPOLIS MN 55402 ADVERTISING SERVICES 836100 13 DENTAL PREMIUMS 524114 129040277 129040277 REV - SELF INSUR GROUP 524114 8972185 8972185 VISION PREMIUMS 524114 3713258 3713258 141725720 1829827 105906 1723921 45615400 39033195 6582205 6582205 6582205 OTHER INCOME 900099 115504 115504 115504 150253256 141841224 105906 8306126 X 380195 380195 5373425 3886137 1487288 8054542 3914162 4140380 445097 321901 123196 1345066 773684 571382 752843 414922 337921 233691 233691 127013 127013 319783 319783 16392630 9929221 6463409 1124085 2134 1121951 165255 89061 76194 932390 532946 399444 275374 229886 45488 69445 49887 19558 13189 13189 410224 296680 113544 279741 279741 PROFESSIONAL DENTAL SVS 97567809 97567809 PREMIUM TAX 1592825 1592825 DUES AND SUBSCRIPTIONS 776230 634867 141363 PRINTING 593156 546623 46533 2046225 1448423 597802 139270233 121311468 17958765 0 12217060 12033615 8153695 10999572 1021397 1060556 11804315 4585413 7420003 7218902 86974462 97376143 10630030 10575558 3280980 3640768 129697627 142905114 12394399 13632340 3082759 1175952 54130 64816 532874 1752722 16064162 16625830 X 113633465 126279284 113633465 126279284 129697627 142905114 X 10983023 1716471 -53675 X 0 1 X 1 0 1530763 1530763 7576325 2482285 5094040 2697227 2103128 594099 7218902 INVESTMENT IN SUBSIDIARY-SOUTHWEST BENEFIT ADM 159123 C INVESTMENT IN SUBSIDIARY-CANYON INSURANCE SVS 592874 C HEDGE FUNDS 9823561 F 10575558 CUSTOMER DEPOSIT LIABILITY 1752722 1752722 X 150643360 1716471 -1006584 709887 149933473 319783 319783 150253256 138950450 0 138950450 319783 319783 139270233 PART X, LINE 2: MANAGEMENT EVALUATES THE COMPANY'S EXPOSURE FOR UNCERTAIN TAX POSITIONS AT EACH REPORTING PERIOD. AS OF DECEMBER 31, 2021 AND 2020, MANAGEMENT BELIEVES THE COMPANY HAS NO MATERIAL UNCERTAIN TAX POSITIONS, AND, THEREFORE, NO SUCH LIABILITIES HAVE BEEN RECORDED. AS OF DECEMBER 31, 2021 AND 2020, THE COMPANY'S UNRECOGNIZED TAX BENEFITS WERE NOT SIGNIFICANT. THERE WERE NO SIGNIFICANT PENALTIES OR INTEREST RECOGNIZED DURING THE YEAR OR ACCRUED AT YEAR END. PART XI, LINE 2D - OTHER ADJUSTMENTS: GAINS/LOSSES FROM CONSOLIDATED RELATED PARTIES -1,006,584. 1 DELTA DENTAL PLAN OF ARIZONA CHARITABLE FOUNDATION AND TRUST 5656 WEST TALAVI BLVD GLENDALE AZ 85306 860842694 501(C)(3) 314129 0 ANNUAL CONTRIBUTION BASED ON BOARD DIRECTIVE TO PROMOTE ORAL HEALTH HONORHEALTH FOUNDATION 8125 N HAYDEN ROAD SCOTTSDALE AZ 85258 742355411 501(C)(3) 18000 0 PROGRAM SUPPORT BOYS & GIRL CLUBS OF THE VALLEY 4309 E BELLEVIEW STREET BUILDING 14 PHOENIX AZ 85008 860550646 501(C)(3) 10000 0 PROGRAM SUPPORT SOUTHWEST HUMAN DEVELOPMENT 2850 N 24TH STREET PHOENIX AZ 85008 860407179 501(C)(3) 7000 0 PROGRAM SUPPORT FUTURE FOR KIDS 1425 W SOUTHERN AVE SUITE 10A TEMPE AZ 85282 861011434 501(C)(3) 6600 0 PROGRAM SUPPORT 5 0 PART I, LINE 2: THE ORGANIZATION'S BOARD RECEIVES REGULAR REPORTS ON THE ORGANIZATION'S ACTIVITIES AND EXPENDITURES OF GRANT FUNDS DONATIONS ARE MADE TO ESTABLISHED, WELL-RESPECTED, LOCAL PUBLIC CHARITY ORGANIZATIONS. AS A RESULT, ONGOING MONITORING OF THE USE OF GRANT FUNDS IS NOT CONSIDERED NECESSARY. X X X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 ALLAN ALLFORD PRESIDENT/CEO (THRU 12/21) 597501 0 363200 0 184227 0 177613 0 28477 0 1351018 0 0 0 BRAD CLOTHIER SENIOR VICE PRESIDENT 433862 0 182500 0 9346 0 94806 0 29247 0 749761 0 0 0 MARK ANDERSON VICE PRESIDENT/CFO 360563 0 211830 0 7477 0 85122 0 32647 0 697639 0 0 0 CRAIG LIVESAY VICE PRESIDENT/COO 321685 0 172098 0 0 0 59774 0 32369 0 585926 0 0 0 LESLIE HESS CHIEF COMPLIANCE OFFICER 270767 0 141910 0 0 0 50945 0 27325 0 490947 0 0 0 MICHAEL JONES PRESIDENT/CEO (BEG 10/21) 98899 0 329539 0 0 0 46298 0 8220 0 482956 0 0 0 SCOTT PEDERSON VICE PRESIDENT 235111 0 87500 0 0 0 50282 0 26122 0 399015 0 0 0 JOLEAN FLECK VICE PRESIDENT, PEOPLE & ORG DEVELOP 203378 0 62500 0 0 0 25484 0 28801 0 320163 0 0 0 HEATHER MOLLON SENIOR DIRECTOR OF CLIENT RELATIONSH 155168 0 62850 0 0 0 0 0 19676 0 237694 0 0 0 ERIC SKARTVEIT SENIOR DIRECTOR OF UNDERWRITING 162492 0 50328 0 0 0 0 0 24613 0 237433 0 0 0 JOHN BRULEY DIRECTOR OF IT 161333 0 42908 0 0 0 0 0 29269 0 233510 0 0 0 JOSHUA CUPERO DIRECTOR OF FINANCE 167417 0 43859 0 0 0 0 0 9240 0 220516 0 0 0 TIFFANY DI GIACINTO SENIOR DIRECTOR OF MARKETING 141786 0 39044 0 0 0 0 0 19623 0 200453 0 0 0 PART I, LINE 1A 1. FIRST CLASS TRAVEL - ALL SENIOR EXECUTIVES ARE OFFERED THIS BENEFIT FOR TRAVEL EXCEEDING 4 HOURS AND IT NOT TREATED AS TAXABLE COMPENSATION. 2. TRAVEL FOR COMPANIONS - THE PRESIDENT/CEO RECEIVES THIS BENEFIT AND IT IS NOT TREATED AS TAXABLE COMPENSATION. 3. HOUSING ALLOWANCE - THE CEO RECEIVED THIS BENEFIT DURING THE YEAR TO COVER TEMPORARY HOUSING UPON RELOCATING TO ARIZONA PART I, LINE 4B THE ORGANIZATION HAS A NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN MEMBERS OF SENIOR MANAGEMENT AS DETERMINED BY THE DDAZ BOARD. PLAN BALANCES ARE CREDITED AT THE DISCRETION OF THE BOARD. IN 2021, ALLAN ALLFORD RECEIVED A DISTRIBUTION OF $144,424 FROM THE NONQUALIFIED DEFERRED COMPENSATION PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NONQUALIFIED DEFERRED COMPENSATION PLAN BUT DID NOT RECEIVE A DISTRIBUTION IN 2021: MARK ANDERSON, CRAIG LIVESAY, BRAD CLOTHIER, SCOTT PEDERSON, LESLIE HESS AND JOLEAN FLECK. PART I, LINE 7 CONSISTENT WITH THE ORGANIZATION'S OVERALL COMPENSATION PHILOSOPHY, OFFICERS, HIGHLY COMPENSATED, AND OTHER DESIGNATED EMPLOYEES PARTICIPATE IN AN ORGANIZATION INCENTIVE COMPENSATION PLAN. THE PLAN CONTAINS METRICS WHICH REPRESENT STRATEGIC PLAN MEASURES THAT ARE DETERMINED ANNUALLY BY THE BOARD OF DIRECTORS. AN OVERALL WEIGHTED SCORE IS CALCULATED BASED ON ACHIEVING A RANGE OF PLAN MEASURES. THE GOALS INCLUDE PRESERVATION OF INCOME WHICH PROVIDES THE ORGANIZATION WITH THE RESOURCES NECESSARY TO ACCOMPLISH ITS CHARITABLE PURPOSES. BRUCE SPIGNER DIRECTOR 138549 CONTRACTED PROVIDER PAYMENTS WERE MADE TO BOARD MEMBER BRUCE SPIGNER CONSISTENT WITH REGULAR COMPANY REIMBURSEMENT RATES. 0 RICHARD B HIGGS DDS PC DIRECTOR 145643 CONTRACTED PROVIDER PAYMENTS WERE MADE TO BOARD MEMBER RICHARD B HIGGS CONSISTENT WITH REGULAR COMPANY REIMBURSEMENT RATES. 0 WARREN AND HAGERMAN DENTAL PLL MICHAEL A. WARREN IS A DIRECTOR 293672 CONTRACTED PROVIDER PAYMENTS WERE MADE TO BOARD MEMBER MICHAEL A WARREN CONSISTENT WITH REGULAR COMPANY REIMBURSEMENT RATES. 0 TANGERINE DENTAL GROUP LLP SHAHARYAR ASHRAF IS A DIRECTOR 111737 CONTRACTED PROVIDER PAYMENTS WERE MADE TO BOARD MEMBER SHAHARYAR ASHRAF CONSISTENT WITH REGULAR COMPANY REIMBURSEMENT RATES. 0 FORM 990, PART VI, SECTION A, LINE 6 ANY ETHICAL DENTIST DULY LICENSED AND IN GOOD STANDING IN THE STATE OF ARIZONA IS ELIGIBLE TO BE A MEMBER OF THE ORGANIZATION. MEMBERS ELECT THE BOARD OF DIRECTORS. MEMBERS DO NOT HAVE AN OWNERSHIP INTEREST IN THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE ORGANIZATION HAVE AUTHORITY TO ELECT DELTA DENTAL'S GOVERNING BODY. NO OTHER GROUP OR PERSON CAN VOTE FOR THOSE WHO SERVE ON THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S BYLAWS MAY BE ALTERED, AMENDED OR REPEALED AND NEW BYLAWS MAY BE ADOPTED ONLY BY THE AFFIRMATIVE VOTE OF TWO THIRDS OF THE MEMBERS PRESENT AT A MEETING OF THE MEMBERS AT WHICH A QUORUM IS PRESENT. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION HAS A PROCESS FOR THE GOVERNING BODY TO RECEIVE AND REVIEW THE 990 BEFORE IT IS FILED. THAT PROCESS INCLUDES THE FOLLOWING STEPS 1. MANAGEMENT'S ENGAGEMENT OF OUTSIDE PROFESSIONAL SERVICES TO PREPARE AND DRAFT THE FORM 990. 2. MANAGEMENT'S REVIEW OF THE DRAFT FORM 990 TO CHECK FOR ACCURACY. 3. PROVIDING THE PROPOSED FINAL DRAFT OF THE FORM 990 TO THE BOARD OF DIRECTORS BEFORE FILING THE DOCUMENT WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A POLICY IN PLACE TO MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICIES WHICH COVER BOTH BOARD MEMBERS AND EMPLOYEES UPON HIRE AND ANNUALLY. THEREAFTER, MEMBERS OF THE GOVERNING BOARD ARE REQUIRED TO EXECUTE THE CONFLICT OF INTEREST POLICY. UPON HIRE, EMPLOYEES ARE REQUIRED TO EXECUTE THE CONFLICT OF INTEREST POLICY. THE ORGANIZATION HAS PROCEDURES IN PLACE TO ALLOW EMPLOYEES AND OFFICERS/DIRECTORS OF THE COMPANY TO REPORT ANY NEWLY CREATED CONFLICTS OF INTEREST. IN ALL INSTANCES INVOLVING AN ACTUAL CONFLICT OF INTEREST, THE CONFLICTED EMPLOYEE OR BOARD MEMBER IS ASKED TO RECUSE HIMSELF FROM DELIBERATIONS ABOUT THE POTENTIAL TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS A PROCESS IN PLACE FOR INDEPENDENT CONSULTANTS TO REVIEW AND REPORT ON COMPENSATION OF THE CEO, OFFICERS, KEY EMPLOYEES, AND BOARD MEMBER COMPENSATION WITH FINAL REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS. THIS INCLUDES REVIEW OF COMPARABILITY, DATA, AND OBTAINING THE INDEPENDENT CONSULTANT'S OPINION OF THE REASONABLENESS OF COMPENSATION DECISIONS MADE BY THE ORGANIZATION. INDEPENDENT CONSULTANT REVIEWS ARE PERFORMED FOR EXECUTIVE STAFF EVERY TWO YEARS AND BOARD COMPENSATION IS PERIODIC. THE INDEPENDENT CONSULTANT'S REPORT AND THE AFFIRMATION OF DISINTERESTED BOARD MEMBERS IS DOCUMENTED IN WRITING IN THE BOARD MINUTES. REVIEWS GENERALLY TAKE PLACE EVERY OTHER YEAR. REVIEWS WERE LAST PERFORMED IN 2020. FORM 990, PART VI, SECTION C, LINE 19 AS REQUIRED BY ARIZONA STATE LAW, THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. THE ORGANIZATION DOES NOT MAKE ITS CONFLICT OF INTEREST STATEMENT AVAILABLE TO ITS MEMBERS OR TO THE PUBLIC. MEMBERS OF THE PUBLIC MAY OBTAIN COPIES OF THE ARTICLES OF INCORPORATION FROM THE ARIZONA CORPORATION COMMISSION. MEMBERS OF THE PUBLIC ALSO MAY OBTAIN COPIES OF DELTA DENTAL'S STATUTORY FINANCIAL STATEMENTS FROM THE ARIZONA DEPARTMENT OF INSURANCE AND FROM THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS. FORM 990, PART IX, LINE 11G OTHER FEES AND EXPENSES: PROGRAM SERVICE EXPENSES 3,908,972. MANAGEMENT AND GENERAL EXPENSES 94,564. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,003,536. DATA PROCESSING: PROGRAM SERVICE EXPENSES 5,134,554. MANAGEMENT AND GENERAL EXPENSES 234. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,134,788. BROKERS COMMISSION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 5,612,887. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,612,887. CONSULTING: PROGRAM SERVICE EXPENSES 885,695. MANAGEMENT AND GENERAL EXPENSES 755,724. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,641,419. FORM 990, PART XI, LINE 9: LOSSES FROM CONSOLIDATED RELATED PARTIES -53,675. ARIZONA DENTAL INSURANCE HOLDINGS LLC 5656 WEST TALAVI BLVD GLENDALE AZ 85306 364589889 HOLDING COMPANY AZ N/A DELTA DENTAL PLAN OF ARIZONA CHARITABLE FOUNDATION AND TRUST 5656 W TALAVI BLVD GLENDALE AZ 85306 860842694 TO IMPROVE ORAL HEALTH ACROSS ARIZONA FOR INDIVIDUALS AND COMMUNITIES AZ 501(C)(3) PF N/A 0 CANYON INSURANCE SERVICE INC 5656 WEST TALAVI BLVD GLENDALE AZ 85306 412139223 INSURANCE AZ AZ DENTAL C 414 594361 1.00000 1 SOUTHWEST BENEFIT AMINISTRATORS LLC 5656 WEST TALAVI BLVD GLENDALE AZ 85306 680586699 ADMIN SERVICES AZ AZ DENTAL C 15387663 161278 1.00000 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0