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Dental Coverage Request Form
This employee benefit varies from state to state. Where available, it is a discounted fee-for service plan
with an annual membership. Components of the plan include savings of up to 50% on dental work; a free, complete
diagnostic exam; and cosmetic dentistry. If you are interested in participating, please contact our Director of
Human Resources who will be happy to provide you with the information applicable to your home office.
I am interested in receiving information about Dental coverage.
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