The Dental Provider Enrollment Assistance line was established to provide assistance to dental providers seeking enrollment into the Denti-Cal program. The Dental Provider Enrollment Assistance Line will be available once a week between 8 a.m. and 4 p.m. as a service to providers who wish to speak with an Enrollment Specialist about their Denti-Cal Enrollment Application Package.

Please fill in the information below to register. After submitting your registration we will send you a confirmation email containing the call-in number. The call-in number will only be accessible for the hours and date of the event.

Question Title

* 1. Dentist or Office Staff Name

Question Title

* 2. Office Address

Question Title

* 3. City

Question Title

* 4. County

Question Title

* 5. Office or Contact Phone Number

Question Title

* 6. Office or Contact Email Address

Question Title

* 7. Where did you hear about the Denti-Cal Enrollment Assistance Line service from?

T