AMENDMENT TO PARTICIPATING DENTIST AGREEMENT – GHP PROGRAMParticipating Dentist Agreement • September 11th, 2018
Contract Type FiledSeptember 11th, 2018This 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.