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Member Benefits - all 3 benefits, one low monthly membership fee

Enrollment


FAMILY ENROLLMENT FORM -
$24.00 per month

Husband and Wife with unlimited number of eligible dependants or parent with 3 or more eligible dependants

Online Order Form


Adult +2 - $18.50 per month
1 adult with no more than 2 eligible dependants

Online Order Form


INDIVIDUAL ENROLLMENT FORM -
$13.00 per month
1 person enrollment form

Online Order Form


Senior - $10.00 per month
1 person 65 years of age or older

Online Order Form

r Form

 

Secure online enrollment form  - Fast and easy
Join today online and start receiving your dental benefits within 30 days!!!!!
 


 


4466 Elvis Presley Blvd. Suite 100
Memphis, Tennessee 38116

901.345.1153   1.800.846.0629


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