Get Maverest Dental Network

Completing the Maverest Dental Network application is a crucial step for dental providers wishing to participate in the network. This guide provides clear instructions to help you accurately fill out the necessary forms online, ensuring a smooth approval process.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the application form and open it in your preferred document editor.
2. Fill out the Office Profile section. Provide your business name, service office address, and contact details accurately. Ensure you indicate if your office is physically accessible.
3. Complete the Dentist Credentialing Information for each participating dentist in your practice. Ensure that all fields related to professional liability, state licenses, and DEA certifications are filled out correctly.
4. Sign the Dentist Attestation Statement at the end of the Credentialing Information section. This confirms that all information is accurate and grants consent for information release related to your credentials.
5. Prepare copies of all required supporting documents, including state dental licenses, DEA certifications, W-9 form, and insurance details. Verify each document for accuracy.
6. Once all sections are complete and documents are gathered, you can save the changes, download the completed application form, and keep a copy for your records.

Begin your application process online today and ensure all forms are filled out accurately for prompt processing.