Nominate Dental Providers

Would you like to refer your dentist to the network? Are you a dentist who knows another dentist who would benefit from partnering with our dental network? If you answered yes to either question, then fill out the form below with the information requested. We’ll do our best to complete our recruiting efforts within 2-6 weeks.

Do you need help filling out the dentist nomination form or do you have questions about nominating a dentist? You can call customer service at 1-800-231-0341 for further assistance.


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