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APPLICATION FOR DENTAL LICENSURE BY CREDENTIALS GEORGIA BOARD OF DENTISTRY 2 Peachtree Street, N.W. 6th Floor Atlanta, Georgia 30303 www.gbd.georgia.gov Please read the instructions carefully and
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Read the instructions provided with the form.
02
Fill in your personal information accurately, such as your name, address, and contact details.
03
Provide your professional qualifications and license information.
04
Specify the type of dentistry practice you are engaged in.
05
Fill out details about your educational background and any specialized training you have received.
06
Include information about any dental associations or organizations you are a member of.
07
Provide a summary of your dental experience and previous employment.
08
Fill in the details of your liability insurance coverage.
09
Include any additional certificates or achievements related to dentistry.
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Review the completed form for any errors or missing information.
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Submit the form as per the instructions provided.

Who needs form practice of dentistry?

01
Dentists who are applying for a license to practice dentistry.
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Dental students who need to complete a form for their practical training or internships.
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Experienced dentists who are changing their practice location or transferring their license.
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Dental professionals who are applying for membership in dental associations.
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Dental administrators or office managers responsible for maintaining accurate records of dentists and their practice details.
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Form practice of dentistry is a document used by dentists to report their practice information to the governing dental board.
All practicing dentists are required to file form practice of dentistry.
Dentists can fill out form practice of dentistry by providing details about their practice, including location, services offered, and patient demographics.
The purpose of form practice of dentistry is to monitor and regulate dental practices to ensure quality care for patients.
On form practice of dentistry, dentists must report information such as practice name, address, contact information, services provided, and number of patients treated.
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