Dental Provider Nomination Form

Love Your Out-of-Network Dentist?

If you want your dentist to participate with United Concordia, please complete the form below. Upon receiving your email, we will contact your dentist.

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The Identification Number is the same for everyone covered on this policy. United Concordia Dental Insurance Card

Dentist Information


Help Us Help You!

Submit your dentist's information using our convenient form and we'll extend an offer to join our network. If your dentist chooses to join, your out-of-pocket costs will automatically be lowered.