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Enrollment Form Small Group Dental Coverage PO Box 75688 Seattle WA 981750688 (800) 5541907 New Open Enrollment COBRA Reinstate Change Description of Changes: Subscriber Information (please complete

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What is is it truehttpswwwdeltadentalwacom?

It is a website for Delta Dental, a dental insurance company.

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Employers who offer dental insurance through Delta Dental.

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To report dental insurance coverage information to the IRS.

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Information on individuals covered under the dental insurance plan.

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