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Delta Dental of California 560 Mission Street, Suite 1300 San Francisco, CA 94105 4159728300SMALL BUSINESS PROGRAM GROUP VISION APPLICATIONAPPLICANT INFORMATION Name of Applicant: Fed. ID/TIN: Contact:

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How to fill out delta dental of california

01

Obtain the necessary enrollment form from Delta Dental of California.

02

Fill out all personal information including name, address, contact information, and social security number.

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Sign and date the form to certify that the information provided is true and accurate.

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Submit the completed form to Delta Dental of California through the specified method (online, mail, in person, etc.).

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What is delta dental of california?

Delta Dental of California is a non-profit dental service corporation that provides dental insurance programs for individuals and groups in California.

Who is required to file delta dental of california?

Employers who offer dental insurance through Delta Dental of California are required to file the necessary paperwork.

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To fill out Delta Dental of California forms, employers need to provide information about the dental insurance plans they offer to their employees.

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The purpose of Delta Dental of California is to help individuals and groups access affordable dental care through insurance programs.

What information must be reported on delta dental of california?

Employers must report information about the dental insurance plans they offer, including employee enrollment and contribution amounts.

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