Get Before August 1, 2010 Dentist Module Ia $285 Module Ia & Ib $875 Auxiliary Module Ia $155

This guide provides clear instructions for filling out the Before August 1, 2010 Dentist Module IA, Module IA & IB, and Auxiliary Module IA forms online. Designed to support users of all experience levels, this step-by-step guide will help ensure accurate completion of the required registration forms.

Follow the steps to successfully complete your registration

1. Press the ‘Get Form’ button to obtain the registration form and open it in your preferred editor.
2. Complete the personal information fields including your first name, last name, title, specialty, and contact details such as address, phone number, fax number, city, state, and zip code.
3. Select the appropriate module you are registering for; choose 'Module IA' for $285, 'Module IA & IB' for $875, or 'Auxiliary Module IA' for $155.
4. Indicate your payment method by checking the appropriate option for either MasterCard, Visa, or check. If paying by credit card, ensure to fill in the card number, expiration date, and total payment amount.
5. List the names of any additional enrollees that you are registering along with your information.
6. Review all entered information for accuracy and completeness.
7. Once all details are verified, save your changes, download or print the form, and share it as necessary.

Complete your registration online today to secure your spot!