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TOLEDO DENTAL SOCIETY PERSONNEL SERVICE APPLICATION DATE POSITION(S) DESIRED: ADDRESS DENTAL ASSISTANT Certified by DAN? Yes No OSB radiography certificate? Yes CITY, STATE, ZIP DENTAL FRONT DESK
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How to fill out toledo dental society 4895:

01
Start by obtaining a copy of the Toledo Dental Society 4895 form. This form is typically available on the society's website or can be obtained from their office.
02
Carefully read the instructions provided with the form to understand the requirements and procedures for filling it out.
03
Begin by entering your personal information in the designated fields. This may include your name, address, contact details, and dental license number.
04
Next, provide any relevant information about your dental practice. This may include details such as the name and address of your practice, your specialty, and any affiliations or certifications you hold.
05
Fill out the section related to your continuing education. This typically involves documenting the courses or workshops you have attended, along with the number of credit hours earned.
06
If applicable, provide information about any disciplinary actions taken against you or any other legal issues that may be relevant.
07
Review all the information you have entered to ensure accuracy and completeness.
08
Sign and date the form in the designated area to certify that the information provided is correct to the best of your knowledge.
09
Make a copy of the completed form for your records before submitting it to the Toledo Dental Society.
10
Keep track of any deadlines or submission requirements specified by the society to ensure timely submission of the form.

Who needs Toledo Dental Society 4895:

01
Dentists who are members of or affiliated with the Toledo Dental Society may need to fill out form 4895.
02
This form is typically required for dentists to provide updates on their personal and professional information, continuing education, and any disciplinary or legal matters.
03
Dentists seeking to maintain their membership or accreditation with the Toledo Dental Society may be required to complete this form on a regular basis as part of their professional obligations.
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Toledo Dental Society 4895 is a form that needs to be filed by dental professionals in Toledo.
Dental professionals practicing in Toledo are required to file the form.
Toledo Dental Society 4895 can be filled out online or submitted in paper form with all required information accurately provided.
The purpose of Toledo Dental Society 4895 is to gather information about dental professionals practicing in Toledo for regulatory and statistical purposes.
Information such as name, contact details, license number, practice location, and services offered must be reported on Toledo Dental Society 4895.
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