| CASE NUMBER | I-200-24081-820228 |
| CASE STATUS | Certified |
| RECEIVED DATE | 3/21/2024 |
| DECISION DATE | 3/28/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | Y |
| BEGIN DATE | 4/1/2024 |
| END DATE | 3/31/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Northern Counties Health Care, Inc. |
| TRADE NAME DBA | Orleans Dental Center |
| EMPLOYER ADDRESS1 | 165 Sherman Drive |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | St. Johnsbury |
| EMPLOYER STATE | VT |
| EMPLOYER POSTAL CODE | 05819 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +18027489405 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Costa |
| EMPLOYER POC FIRST NAME | Michael |
| EMPLOYER POC MIDDLE NAME | Kenneth |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 165 Sherman Dr |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | St. Johnsbury |
| EMPLOYER POC STATE | VT |
| EMPLOYER POC POSTAL CODE | 05819 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +18027489405 |
| EMPLOYER POC PHONE EXT | 1513 |
| EMPLOYER POC EMAIL | michaelc@nchcvt.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Collier |
| AGENT ATTORNEY FIRST NAME | Sidney |
| AGENT ATTORNEY MIDDLE NAME | Ellen |
| AGENT ATTORNEY ADDRESS1 | 27 Main Street |
| AGENT ATTORNEY ADDRESS2 | Suite 12 |
| AGENT ATTORNEY CITY | Montpelier |
| AGENT ATTORNEY STATE | VT |
| AGENT ATTORNEY POSTAL CODE | 05602 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +18025229901 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | scollier@collierimmigration.com |
| LAWFIRM NAME BUSINESS NAME | Law Office of Sidney Collier |
| STATE OF HIGHEST COURT | VT |
| NAME OF HIGHEST STATE COURT | Supreme Court of Vermont |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 11 Union Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Orleans |
| WORKSITE COUNTY | DERBY |
| WORKSITE STATE | VT |
| WORKSITE POSTAL CODE | 05860 |
| WAGE RATE OF PAY FROM | 130000 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $150,000.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $100,568.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Collier |
| PREPARER FIRST NAME | Sidney |
| PREPARER MIDDLE INITIAL | E |
| PREPARER BUSINESS NAME | Law Office of Sidney Collier |
| PREPARER EMAIL | scollier@collierimmigration.com |
| BEGIN DATE CONVERTED | 2024-01-04 |
