Reminder:DentSaveSM is currently available only in the New York City metropolitan area.

To register your enrollment just follow these simple steps:

Complete the enrollment form and the credit card information to cover the one-time non-refundable registration fee.
When you complete the online form and send it to us for processing we will complete your DentSaveSM discount dental
membership program enrollment and email you your identification card and welcome letter.

When you receive your new enrollment information you are ready to use the program.
      a)  Call the dentist you want to use; please confirm their current participation in the program.
      b)  Identify yourself as a DentSaveSM  Discount Dental Program Member
      c)  Set up your dental appointment

 

1.  Enter the following information for the primary member.


Sex: 

First Name: 

Last Name: 

Street Address:  

City: 

State: 

Zip: 

Email:

Telephone # (no dashes):  

  

 

2. List the name(s) of all other members of your household who are to be covered by this membership.
ALL FAMILY MEMBERS WILL CONTINUE TO BE COVERED FOR AS LONG AS THEY CONTINUE TO RESIDE IN YOUR HOUSEHOLD.

Sex

First Name

Last Name



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