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Group Benefits Dental Claim PART 1 DENTIST LAST CAREGIVER NAME A T ADDRESS I E N CITY UNIQUE NO.APT.PROV.POSTAL CODES PEC.PATIENT\'S OFFICE ACCT. NO. D E N T I S T PHONE NO. I HEREBY ASSIGN MY BENEFITS
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What is dental care services?
Dental care services include services such as cleanings, x-rays, fillings, extractions, and other procedures to maintain oral health.
Who is required to file dental care services?
Dental care providers such as dentists, orthodontists, and oral surgeons are required to file dental care services.
How to fill out dental care services?
Dental care services can be filled out using specific forms provided by insurance companies or government agencies.
What is the purpose of dental care services?
The purpose of dental care services is to provide preventive and corrective treatment for oral health issues.
What information must be reported on dental care services?
Information such as patient demographics, treatment provided, dates of services, and insurance information must be reported on dental care services.
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