Long Term Membership Application

Six Easy Steps to Joining Savon Dental Plan:
Select State	Select Dentist	Select Plan	Complete Application	Submit App. & Payment	Print ID card

Long Term Enrollment Application - Continued

Please tell us in which plan you are enrolingl
Basic Plan - most comprehensive single state coverage available (not available in all states)
	Single	3 yr plan: $249.00	4 yr plan: $329.00	5 yr plan: $389.00

	Double	3 yr plan: $339.00	4 yr plan: $469.00	5 yr plan: $569.00

	Family	3 yr plan: $469.00	4 yr plan: $629.00	5 yr plan: $720.00

Price includes a one-time $20.00 processing fee

Clicking this button moves you to our secured site to complete your application.

Savon Dental Plan Is Not Available For Purchase In The State Of Florida

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This is not dental insurance and is not intended to replace insurance.
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