DEPARTMENT OF INSURANCE

Insurer Details

NAME	Premier Dental Network Inc.
DOI ID	300661
FEIN #	611209705
ALIEN #
State of Domicile	KY
Domicile Country
Merged Into
NAIC #	52094
NAIC Group #
Entity Type	Insurer
Admitted	12/9/1991
AM Best Rating
President	Robert E. Thieman
Process Agent	Robert E. Thieman Date Assigned : 3/9/1998 (See address table below for process agent address)
Authorized Insurer – these insurers are authorized to do the business of insurance by holding a Kentucky Certificate of Authority. Provides insurance coverage.

Type	Address
Mailing	209 Breckenridge Lane Louisville, KY 402073824
Process Agent	209 Breckenridge Lane Louisville, KY 402073824
Statutory Home Office	209 Breckenridge Lane Louisville, KY 402073824

Type	Number
Business / Home Office	(502) 899-3700