Medicaid Dental Unit Provider Agreement Sample Contracts

AMENDMENT

Medicaid Dental Unit Provider Agreement • May 5th, 2020 • Vermont

• Contract Type
  Medicaid Dental Unit Provider Agreement
• Filed
  May 5th, 2020
• Jurisdiction
  Vermont

It is agreed by and between the State of Vermont, Department of Vermont Health Access (hereafter called the “State”) and John Holbach, DDS, (hereafter called the “Contractor”) that the contract on the subject of being the State’s Medicaid Dental Unit Provider, effective July 1, 2015, is hereby amended effective July 1, 2016, as follows: