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Consent For Treatment Form
Notice of Privacy Practices
Dental Materials Fact Sheet
If you do not have dental insurance, we are pleased to provide the following:
DENTAL MEMBERSHIP PLAN
2 Routine cleanings per year (includes fluoride for children) 2 Exams per year Check up x-rays 15% off any additional needed treatment *
Adults: $255 Children (12 and under) $155
*Valid for one year from the date of purchase. 15% discount not valid with CareCredit
For your convenience we gladly help you bill your insurance.
We accept most dental PPO's and are preferred providers with many major PPO's including:
ADDP Dental Aetna Ameritas Assurant/DHA Blue Cross Blue Shield
Delta Dental PPO
Delta Dental Premiere Dentemax
First Dental Health GEHA Connection Dental
Metlife Premier Access
United Concordia United Healthcare
If you do not see your insurance plan on our list, please give us a call at 916-939-6900 and we will gladly check for you.
NOTE: If you have been recently been diagnosed with any type of heart condition, systemic infection, have or plan to have any type of surgery in the near future, please call our office at 925.373.7311 so we can verify with your doctor if you need pre-treatment medications.