MARYLAND ORTHODONTIC PROVIDER AGREEMENTMaryland Orthodontic Provider Agreement • July 18th, 2017
This Agreement is made and entered into this day of , (year), by and between (hereinafter referred to as ORTHODONTIST) who is qualified and appropriately licensed to practice Dentistry in the state of Maryland, and Dominion Dental Services, Inc. and Dominion Dental Services USA, Inc both Virginia Corporation (hereinafter referred to collectively as a PLAN). Whenever mentioned herein, the term ORTHODONTIST shall include all employees of ORTHODONTIST, all partners, dental associates, and all staff personnel under his direct supervision and/or control. The provisions of this Agreement are to be construed according to the laws of the State of Maryland. In the event of any inconsistency between this Agreement and the terms of any coverage contract, the terms of such coverage contract shall control.
