SS Application | Midwestern Dental - Full Service Dentistry, Orthodontics, Teeth Whitening, Periodontics

A Lifetime of Good Dental Health!

At Midwestern Dental, we're proud of the fact that we've listened to our patients and developed a dental practice that caters to individual needs. Our patient's dental health is our top priority!

Full Service Dentistry

Routine Checkups & Cleanings

Orthodontics

Oral Surgery

Periodontics

Implants

Cosmetic Dentistry

Selecting the right dental group that will satisfy your family's dental needs is not always easy, but it is important.

24-Hour Emergency Assistance

Day, Evening & Saturday Appts

7 Convenient Locations (view)

Patient Forms and Dental Plan Information

Patient Registration Forms

Notice of Privacy Practices

Smile Savers Discount Plan

Midwestern Dental Plans, Inc.

Participating Insurance Plans

Financial Arrangements

SMILE SAVERS ENROLLMENT APPLICATION

Complete the enrollment application form below and you will be directed to PayPal for secure online
payment using Visa, Mastercard, American Express or Discover. You do not need a PayPal Account.
Learn more about PayPal

ANNUAL MEMBERSHIP
Member $89 / Family $169 (up to 4 members)*

* Dependents shall mean children up to age 19 and full time students to age 23.
All other members must pay the $89 for their own account.

Prefer to apply by mail?

Download Enrollment Application

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