Advanced Adult Care Plan

Centre Dental

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Advanced Adult Care Plan

Select Plan

Yearly - $299.00
Adult Care Plan-Enhanced
Yearly - $399.00
Advanced Adult Care Plan

Personal information

Name

First

Last

Birthday

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Payment Details

Card Number

Layout

Expiration Date

CVC

Each member must leave a valid credit card on file for auto-renewal. If the charge is denied, a member has 15 days to make alternative payment. If the membership is lapsed, a $25 reactivation fee will be applied. If membership is lapsed more than twice, future sign up is prohibited. Any unused benefits will expire once membership expires. Only uninsured patients are eligible to apply for membership. Membership is not transferable. No refund is allowed once any service item in the membership benefits is used.

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