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Thousands of dental offices have found that joining our PPO panel is easy and financially
beneficial to their practices. To become a network provider, please print &
complete the
Provider Agreement form and
W-9 form
and mail them with the following items to our Provider Relations Department: (For
more information please refer to
Provider Forms)
Copies of your (and your Associates')
- Copy of the Wallet-size dental license
- Copy of the DEA license
- Copy
of the CPR
- Copy of the Malpractice Insurance declarations page
Mail to:
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Premier Access Insurance Company
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Attn: Provider Relations Department
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P.O. Box 659010, |
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Sacramento, CA 95865-9010 |
For more information about this plan, please
Contact Us
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