DENTAL ASSURANCE PROGRAM AVAILABLE AT ADVANCED DENTISTRY SUGAR LAND

COVERAGE AND BENEFITS AS FOLLOWS:

• 2 EXAMS: (Limited/Routine) 100%
• 2 HEALTHY MOUTH CLEANINGS/PERIO MAINT. 100%
• ALL DIAGNOSTIC X-RAYS 100%
• FILLINGS 20%
• EXTRACTIONS 20%
• ROOT CANALS 20%
• CROWNS (Lab fees may apply) 20%
• BRIDGES (Lab fees may apply) 20%
• REMOVABLE PROSTHETICS 20%

(ONLY valid at Advanced Dentistry)

ANNUAL PRICE:

SINGLE COVERAGE $495.00

ADDITIONAL FAMILY MEMBER(S) COVERAGE $395.00

Excludes Implant and Cosmetic Services

No calendar year maximum

No waiting periods

No pre-existing conditions or exclusions

Patient agrees with the Dental Assurance Program.