Fill out our quick form and get pre-approved for up to
$5,000
of dental treatment!
Monthly payments available for braces, dentures, dental implants, wisdom teeth removal and more.
Please enter your insurance situation
Do you have dental insurance?
Yes, I do
No insurance
State Sponsored (Medicare, Medicaid, Indiana HIP)
Please select your provider
Please select your provider?
AETNA PPO Program
Ameritas
Anthem 300
ASR
Assurant
Cigna PPO Program
Delta Dental Premiere Program
Dentamax Network
Guardian
Health Resources Inc. DHMO Program
Humana
Maverest PPO Program
MetLife PPO Program
I have dental insurance that is not on this list.
Please enter employment status
Are you currently employed?
Full Time Employment
Part Time Employment
I Am Retired
I Am Unemployed
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Do you have verifiable income?
I Can Verify My Income
My Income Is Not Verifiable
You did not specify if you have a co-signer.
Do you have co-signer?
I Have A Co-Signer
I Do Not Have A Co-Signer
You did not specify if your co-signer had verifiable income.
Does your co-signer have a verifiable income?
My Co-Signer Has Verifiable Income
My Co-Signer Cannot Verify Their Income
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2
complete!
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