Adult Wellness Plan                                                    $299.00 per year

• 1 routine cleaning every 6 months                           Savings of $407.00 per year
• Regular exam with cleaning
• Oral Cancer Screening
• 1 set of routine x-rays per year
• Up to 15% off additional treatment

Child Wellness Plan                                                     $249.00 per year

• 1 routine cleaning every 6 months                           Savings of $438.00 per year
• Fluoride treatment with cleaning
• Regular exam with cleaning
• Oral Cancer Screening
• 1 set of routine x-rays per year
• 1 emergency exam with x-ray per year
• Up to 15% off additional treatment

Peio Maintenance Plan                                                 $499.00 per year

• 1 perio maintenance every 3 months                       Savings of $419.00 per year
• 2 regular exams per year
• Oral Cancer Screening
• 1 set of routine x-rays per year
• 1 emergency exam with x-ray per year
• Up to 15% off additional treatment

1. Benefits are effective immediately upon enrollment and effective for 1 (one) year from date of enrollment.
2. This Not a form for dental insurance. It is a membership plan to assist our patients and families to obtain the dental care they need at an affordable price.
3. Cannot be combined with other dental plans or insurance.
4. No membership card is provided. Membership information will be kept on file at Miranda Dental.
5. After 90 calendar days NO refund or premium will be provided.
6. Patient portion of bill is due at time of service.
7. Office fees schedule is subject to change.