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WELCOME MDC Dental Clinic Patient Information Date Patients Name Male Female (circle one) Social Security # (required) Date of Birth T19/Medicaid ID # (required) Address of Patient City State Zip

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What is mobile dental centers?

Mobile dental centers are dental facilities that are able to provide services outside of a traditional dental office, typically through a vehicle that is equipped with dental equipment and tools.

Who is required to file mobile dental centers?

Mobile dental centers are typically required to be filed by the dental professionals or organizations operating the mobile dental facility.

How to fill out mobile dental centers?

Mobile dental centers can be filled out by providing information about the location, services offered, equipment used, and any other relevant details regarding the operation of the mobile dental facility.

What is the purpose of mobile dental centers?

The purpose of mobile dental centers is to bring dental services to underserved communities, remote areas, or locations where access to traditional dental offices may be limited.

What information must be reported on mobile dental centers?

Information that must be reported on mobile dental centers typically includes the name and contact information of the operator, location of the facility, services provided, and any certifications or licenses held.

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