Common Contracts

AMENDMENT TO PARTICIPATING DENTIST AGREEMENT – GHP PROGRAM

Participating Dentist Agreement • September 11th, 2018

• Contract Type
  Participating Dentist Agreement
• Filed
  September 11th, 2018

This document constitutes an amendment to the Participating Dentist Agreement (“Dentist Agreement”) previously entered into by Delta Dental of Puerto Rico, Inc. (“DDPR”) and the participating dentist(s) or dental group whose name(s) appear(s) below (“Participating Dentist” or “Dentist” or “Provider”). This Amendment shall become effective on the date it is signed by Dentist.