| LCA CASE NUMBER | I-200-20278-857121 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-10-04 |
| DECISION DATE | 2020-10-09 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Pediatric Dentist |
| SOC CODE | 29-1029.00 |
| SOC TITLE | Dentists, All Other Specialists |
| FULL TIME POSITION | False |
| LCA CASE EMPLOYMENT START DATE | 2020-10-12 |
| END DATE | 2023-10-11 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 1 |
| LCA CASE EMPLOYER NAME | Pediatric Dental Center of Frederick, LLC |
| EMPLOYER ADDRESS1 | 7360 Guilford Drive |
| EMPLOYER ADDRESS2 | Suite 102 |
| EMPLOYER CITY | Frederick |
| EMPLOYER STATE | MD |
| EMPLOYER POSTAL CODE | 21704 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 13016682662 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Mansman, II |
| EMPLOYER POC FIRST NAME | Robert |
| EMPLOYER POC JOB TITLE | Owner |
| EMPLOYER POC ADDRESS 1 | 7360 Guilford Drive |
| EMPLOYER POC ADDRESS 2 | Suite 102 |
| EMPLOYER POC CITY | Frederick |
| EMPLOYER POC STATE | MD |
| EMPLOYER POC POSTAL CODE | 21704 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 13016682662 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Mendoza |
| AGENT ATTORNEY FIRST NAME | Radlyn |
| AGENT ATTORNEY MIDDLE NAME | Christine |
| AGENT ATTORNEY ADDRESS1 | 909 First Colonial Drive |
| AGENT ATTORNEY ADDRESS2 | Suite 100 |
| AGENT ATTORNEY CITY | Virginia Beach |
| AGENT ATTORNEY STATE | VA |
| AGENT ATTORNEY POSTAL CODE | 23454 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 17574649224 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Gardner & Mendoza, pC |
| STATE OF HIGHEST COURT | VA |
| NAME OF HIGHEST STATE COURT | Supreme Court of Virginia |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 7360 Guilford Drive |
| WORKSITE ADDRESS2 | Suite 102 |
| LCA CASE WORKLOC1 CITY | Frederick |
| WORKSITE COUNTY | FREDERICK |
| LCA CASE WORKLOC1 STATE | MD |
| WORKSITE POSTAL CODE | 21704 |
| LCA CASE WAGE RATE FROM | 74.58 |
| LCA CASE WAGE RATE TO | 85 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 74.58 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | III |
| 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 |
