In-House Membership Plans

Terms and Limitations of the Plans:

• Family members cannot be substituted in for one-another
• Effective date is the date signed up
• Renewal date is 1 year from the sign up date
• Cleanings must be performed before the end of the coverage date
• This is a dental discount membership plan NOT dental insurance (cannot be combined with insurance)
• Payment is due at time of service for any work not covered at 100%
• Rates are subject to change annually

In-House Dental Membership Financing Plan Child (14years & under) $200

Examinations:

New Patient / Comprehensive Exam	100%
Periodic Exam (two/year)	100%
Emergency Exam (one/year)	100%

Radiographs:

Bitewing x-rays (two sets/year)	100%
Peri-apical x-rays (4PA's/year)	100%
Full mouth/Panoramic (one every 3 years)	100%

Preventive Care:

Cleanings	100%
Fluoride (two/year)	100%

Periodontal Services by Hygienist:

Deep Cleanings/Scaling and root planning	20%
Antimicrobial Application	20%

In-House Dental Membership Plan Child (14years & under) 4 Cleanings/Year $350

Examinations:

New Patient / Comprehensive Exam	100%
Periodic Exam (two/year)	100%
Emergency Exam (one/year)	100%

Radiographs:

Bitewing x-rays (two sets/year)	100%
Peri-apical x-rays (4PA's/year)	100%
Full mouth/Panoramic (one every 3 years)	100%

Preventive Care:

Cleanings	100%
Fluoride (two/year)	100%

Periodontal Services by Hygienist:

Deep Cleanings/Scaling and root planning	20%
Antimicrobial Application	20%

In-House Dental Membership Plan Adult Perio Member $400

Examinations:

New Patient / Comprehensive Exam	100%
Periodic Exam (two/year)	100%
Emergency Exam (one/year)	100%

Radiographs:

Bitewing x-rays (two sets/year)	100%
Peri-apical x-rays (4PA's/year)	100%
Full mouth/Panoramic (one every 3 years)	100%

Preventive Care:

Cleanings

100%

Periodontal Services by Hygienist:

Deep Cleanings/Scaling and root planning	20%
Antimicrobial Application	20%