TEXAS PROVIDER AGREEMENTProvider Agreement • March 25th, 2022 • Texas
Contract Type FiledMarch 25th, 2022 JurisdictionTHIS PROVIDER AGREEMENT (the “Agreement”) is made and entered into by and between LIBERTY Dental, P.A., a Texas Professional Association ( “LIBERTY”), and [legal name of dental office]: ("Dental Office"),
TEXAS PROVIDER AGREEMENTProvider Agreement • March 12th, 2021 • Texas
Contract Type FiledMarch 12th, 2021 JurisdictionTHIS PROVIDER AGREEMENT (the “Agreement”) is made and entered into by and between LIBERTY Dental, P.A., a Texas Professional Association ( “LIBERTY”), and [LEGAL NAME OF DENTAL OFFICE]: ("Dental Office"),