I hereby make application for membership in the Pinellas County Dental Association and agree to abide by the By-Laws of the organization.
I understand that my membership in the Pinellas County Dental Association will be provisional for a period of one year, upon acceptance and that active status is dependent upon membership in the West Coast District Dental Association, The Florida Dental Association and the American Dental Association during this one year period.
Your personal contact information will not be shared with anyone outside of the organization.
Your name, office address, office phone and office website will be placed online at www.smilepinellas.org in the Find-a-Dentist section.