Appleton Dental Plan

 

 

Appleton Dental Plan Contact Information

 

 
 

 

Provider Application Area

 

Thanks for your interest in joining the Appleton Dental Plan team!  There are two steps that must be completed to initiate the application process.  If you have any questions regarding the plan, or the application process, feel free to contact us.

 

 

Step One:  Complete the Provider Information Application Form

 

Two options for completing the application are available, online or offline:

 

1.  You can print the the Provider Information Application in PDF format (84Kb download), fill it out and mail it to us, or...

 

2.  Do it online!  Complete and submit the application in a secure online environment.

 

Step Two:  Complete the Provider Membership Agreement

 

There are also two ways to accomplish this:

 

1.  You can print out the Provider Agreement in PDF format (86Kb download), sign it and mail it to us, or...

 

2.  Choose to read and consent to the agreement in a secure area.

 

 

 

Join the Appleton Dental Plan Provider Network. It's easy!

 

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