Become a Provider

If you are interested in joining the FCL Dental networks, call 1.877-493-6282. A representative will assist you and can initiate the online application process for you. You can also send an email with your name, phone number, office name and office address to [email protected] Once you complete the online application, we will ask you to send additional forms and credentials, including:

• W-9 form
• Current dental license
• Current drug enforcement agency (DEA) certificate (not required for orthodontists)
• Certificate of specialty training (if applicable)
• Current professional liability policy declarations page FCL's e-on boarding tool allows you to complete, sign and submit all required documents electronically, including required credentials to participate in the FCL Dental network. This helps your dental practice by eliminating the manual paper process and processing your information more quickly.

To learn more, e-mail [email protected] or call 1-877-493-6282

If you would like to nominate a dentist, CLICK HERE