Benefits are effective immediately upon enrollment and effective for 1 (one) year from date of enrollment.
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.
Cannot be combined with other dental plans or insurance.
No membership card is provided. Membership information will be kept on file at Miranda Dental.
After 90 calendar days NO refund or premium will be provided.
Patient portion of bill is due at time of service.