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First Time Dentist Signup

Signup by correctly entering all requested information below, and then clicking Submit.

Please enter the information. All fields required:
Dental Entity Name:
Tax Id Number:
Primary Provider:
Office Address:
City:
State:
Zip:
Phone:
E-Mail Address:
User Name:
Password: At least 7 characters
Re-Enter Password:
           


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Fidelio Dental Insurance Company © 2018
2826 Mount Carmel Avenue • Glenside, PA 19038 • USA • Tel: 215-885-2443