The Forms Most Commonly Used By Savon Dental Plan Providers

All but one of these forms are in a PDF format, so you need to have Adobe® Acrobat Reader.  If you do not have it, you may download it for free at www.acrobat.com.

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Forms completed in the PDF format may be mailed to Savon at PO Box 54277, Phoenix, AZ 85078 or scanned and emailed to ProviderServices@SavonDentalPlan.com.
Forms that were downloaded in the Excel format should be emailed to ProviderServices@SavonDentalPlan.com.

2024-2025 Fee Schedule Update Survey - this survey is in progress until July 15, 2024
Download the fee schedule update survey in Excel format
Open and save the fee schedule update survey in PDF format
Existing Providers Only - Add new dental centers and dentists (General and Specialists)
Add another General Dentist and facility
Add a General Dentist to an existing facility
Add another Specialist and speciality facility
Add a Specialist to an existing speciality facility
Urban and Rural fee schedules for each state
Download the official, full color Schedule of Benefits for your State

Have a question or comment?  Email provider services or call us at 1-602-841-3494.