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South High Dental New Patient Information
Please submit the following form before your upcoming appointment. We all look forward to meeting you!
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Dental Insurance Provider
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Please select your dental insurance provider
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Delta Dental
Aetna
Metlife
Cigna
United Healthcare- Medicaid/Medicare
United Healthcare- Through My Employer
United Concordia
Dentamax
Medicare, Medicaid, Caresource, Molina, Paramount, or Buckeye Health Plan
Other
I have no dental insurance
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