Registration Form
Please print and complete the following form before your first appointment.
Insurance
We accept most insurance plans and will gladly process your insurance claim. Please bring your insurance card with you on your first visit.
We are in-network with several major providers including:
- Aetna
- Ameritas
- Anthem Blue Cross Blue Shield
- Careington
- Cigna
- Delta Dental
- DNOA
- DenteMax
- GEHA
- Guardian
- Humana
- MetLife
- Principal
- Sun Life
- United Concordia
- UnitedHealthcare
- and more…
Even for plans where we are out-of-network, we will still accept and process your insurance claims. Most insurance carriers allow you to see the dentist of your choice, but you may need to confirm with them. Out-of-pocket costs may be slightly higher for some out-of-network services as well.
For uninsured patients, our goal is to meet your needs and provide affordable options to ensure you receive necessary dental care. Please mention the $149 New Patient Special when you call to make an appointment.
New Patient Specials
We are pleased to offer the following New Patient Special.
