To make the process quicker you can fill out the form below or you can download, print, and fill out the following form here
Adult Individual Plan
$475 per year*
(12 months of coverage)*
Ages: 18-99
Teen Individual Plan
$375 per year*
(12 months of coverage)*
Ages: 12-17
Adult Periodontal Maintenance Plan
$475 per year*
(12 months of coverage)*
Ages: 18-99
*Payment made in full at the start of the plan
Start saving on your dental care today! Call Lebanon Dental at (765) 482-5762 to sign up for our plan or to schedule an appointment.
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