Dental Office Application With No Insurance In Clark
Category:
State:
Multi-State
County:
Clark
Control #:
US-00413-1
Format:
Word;
Rich Text
Instant download
Description
This form is an Employment Application. The form provides that applications are considered without regard to race, color, religion, or veteran status.
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Save time and hassle with our patient resources in Clark, NJ. Call Gary I. Borker, DMD at . Fill out your patient forms at home!We will file any outstanding charges to your dental insurance carrier. Ages 18 to 64 with no insurance. Insurance and Billing We accept most traditional insurance plans, contact our office to verify acceptance of your plan. For patients who have little or no dental insurance coverage, flexible payment programs can be arranged to help you make your dental treatment more affordable. We offer family dentistry, general dentistry, and cosmetic dentistry services in Millburn and Clark, New Jersey, to keep your smile healthy and bright. After your dentist fills out the form, send it and your original itemized bills to Blue Cross Blue Shield of Massachusetts,. P. O. Box 986030, Boston, MA 02298.