Individual and Family Discount Dental Plans and Insurance, Affordable Dental Coverage Starting at $79.95 a Year!

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 DentalPlans.com > Help > Network Provider Application
The following "Network Provider Application" is for Dental or Dental Specialty Providers ONLY! If you are a consumer and you would like a specific dentist to be contacted regarding participation in one or more of our plans, click here!

If you are interested in becoming a Participating Provider in one or all of the discount dental plan(s), please fill out the following Network Provider Application. By doing so, your activation process will be expedited.

Please fill out the following application in order to get started:

Network Participating Provider Application
Dental Office Name:
Owned by:
Dentist's Full Name:  
Email Address:
Street Address:
City:    
State:
ZIP:
Business Phone:   
Fax Number:   
 
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Plans offered by DentalPlans.com are not dental insurance policies and the plans do not make payments directly to the providers of dental services. The plan member is obligated to pay the dentist for all the dental care services that he or she will receive, but, he or she will receive a pre-negotiated discount from the dentists listed as providers in the network in accordance with the specific pre-negotiated discounted fee schedule. The dental plans provide discounts at certain dentists for dental services.

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