| LCA CASE NUMBER | I-200-21067-127816 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-03-08 |
| DECISION DATE | 2021-03-15 |
| 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 | 2021-09-05 |
| END DATE | 2024-09-04 |
| 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 | Baystate Dental Practice, LLC |
| EMPLOYER ADDRESS1 | 1795 Main Street |
| EMPLOYER ADDRESS2 | Suite 212 |
| EMPLOYER CITY | Springfield |
| EMPLOYER STATE | MA |
| EMPLOYER POSTAL CODE | 1103 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14137325600 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Haluch |
| EMPLOYER POC FIRST NAME | Matthew |
| EMPLOYER POC JOB TITLE | PC Owner |
| EMPLOYER POC ADDRESS 1 | 1795 Main Street |
| EMPLOYER POC ADDRESS 2 | Suite 212 |
| EMPLOYER POC CITY | Springfield |
| EMPLOYER POC STATE | MA |
| EMPLOYER POC POSTAL CODE | 01103 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14137325600 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Roeper |
| AGENT ATTORNEY FIRST NAME | Jennifer |
| AGENT ATTORNEY MIDDLE NAME | Gail |
| AGENT ATTORNEY ADDRESS1 | 100 N Tampa Street |
| AGENT ATTORNEY ADDRESS2 | Suite 3600 |
| AGENT ATTORNEY CITY | Tampa |
| AGENT ATTORNEY STATE | FL |
| AGENT ATTORNEY POSTAL CODE | 33602 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 18132217258 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Ogletree Deakins Nash Smoak & Stewart, P.C. |
| STATE OF HIGHEST COURT | FL |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 29 Broad Street |
| LCA CASE WORKLOC1 CITY | Westfield |
| WORKSITE COUNTY | HAMPDEN |
| LCA CASE WORKLOC1 STATE | MA |
| WORKSITE POSTAL CODE | 1085 |
| LCA CASE WAGE RATE FROM | 163384 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 141627 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Brigham |
| PREPARER FIRST NAME | Jennifer |
| PREPARER MIDDLE INITIAL | L |
| PREPARER BUSINESS NAME | Ogletree Deakins |
| PREPARER EMAIL | [email protected] |
