Dentists Online Registration

Individual Dentist Registration - Tax Identification Number

You've selected our Individual Dentist registration option. To review, you'll be able to access the following information for the locations where you practice: patient specific benefits, eligibility and claims information. In addition you'll be automatically registered in our national database, allowing you access to Delta Dental plan websites nationwide. You will need your License Number and Tax Identification Number (TIN) to register.

To continue, please enter and confirm your License Number, TIN and State

License #: Confirm License #:
TIN: Confirm TIN:
State:

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