Federal Incentive Eligibility Survey
Fill out the information below and we will contact you with more information about your eligibility
Name of Group or Practice
Your answer
Contact Name
Your answer
Contact Email
Your answer
Contact Phone Number
Your answer
Number of Locations
Your answer
Current Dental Software Product
What dental software does your group or practice use?
Your answer
Number of dentists
Your answer
How many dentists on your staff had at least 30% Medicaid visits for a 90 day period in 2015 or 2016? [Optional]
Your answer
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