New to the network
Thank you for your interest in becoming a dental network provider. The first step is to let us know that you’d like to join our network.
Please click below to submit an online application:
General Dentists, Endodontist, Orthodontist, Periodontist, Pediatric Dentists and Oral Surgeons
To prevent delays in processing, please be sure to include:
- W-9
- Provider roster
- Document attachments in PDF format
- Provider Add Form for each individual provider
After submitting an online application, what happens next?
- Your application will be assigned to a contracting representative.
- Your application will be reviewed within 30 business days.
- Oral Surgeons require credentialing. You will be directed to submit credentialing applications.
- After all required documents have been received and processed, contracts will be sent for your review and signature.
- Once signed contracts are returned, they will be submitted to the network for final execution and an effective date.
