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  • Express Scripts Dental Provider Enrolment Form

Get Express Scripts Dental Provider Enrolment Form

DENTAL PROVIDER ENROLMENT FORM NON-INSURED HEALTH BENEFITS (NIHB) PROGRAM Complete, sign and return ALL pages of the Enrolment Form by fax or mail to: Fax No.: 905-712-0669 Mail: Express Scripts Canada,.

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Please note that this does not affect NIHB dental claim statements. If you have any questions regarding this communication, please contact the Express Scripts Canada Provider Call Centre at 1 800 563-3274.

Express Scripts Canada is a leader in health benefits management. We stay ahead of the curve by focusing on innovation and leveraging data to focus on what matters most to those we serve: better health benefits for less.

If you have any questions regarding this communication, please contact the Express Scripts Canada Provider Call Centre at 1 800 563-3274.

Creating a better future – together. Express Scripts Canada is a leading health benefits manager in Canada and has been recognized as part of the most innovative pharmacy benefit manager (PBM) in the world. As industry leaders, innovation is at the forefront of everything we do.

“Express Scripts Pharmacy” refers to ESI Mail Pharmacy Service, Inc.

To get started, grab your Express Scripts ID card and visit .express-scripts.com. If you have questions, please call Express Scripts toll-free at 866‑685‑2792 (non-Medicare enrollees) or 888‑416‑3326 (Medicare enrollees).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232