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STATE OF NEW MEXICOMICHELLE LUJAN GRISHAM, GOVERNOR Linda M. Trujillo, Superintendent John Blair, Deputy Superintendent MEXICO STATE BOARD OF DENTAL HEALTH AUTHORIZATION FOR DISCLOSURE OF HEALTH RECORD
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How to fill out nmbodhc statement of dentist

01
Begin by providing your personal information such as your name, address, and contact details.
02
Specify your qualifications and experience as a dentist.
03
Describe the nature of your practice and the services you offer.
04
Include any special certifications or training you have received.
05
Sign and date the statement to certify its accuracy.

Who needs nmbodhc statement of dentist?

01
Dentists who are applying for membership or accreditation with a professional dental organization.
02
Dentists who are seeking to update their credentials for licensing or credentialing purposes.
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The nmbodhc statement of dentist is a form required to be filed with the state dental board to report certain information about dental practices.
All licensed dentists are required to file the nmbodhc statement of dentist.
The nmbodhc statement of dentist can be filled out online through the state dental board's website or by submitting a paper form by mail.
The purpose of the nmbodhc statement of dentist is to ensure transparency and accountability in dental practices by reporting certain information to the state dental board.
Information such as name of the dentist, practice address, services provided, and any disciplinary actions must be reported on the nmbodhc statement of dentist.
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