You MUST provide us with either:
YOUR employment information - OR -
Employment information for your SPOUSE or domestic partner
If you are not working and you do not have a spouse/domestic partner who is working, you do not qualify to be a patient.
Do not continue this application. Instead, click here to view other resources for dental care that may be available to you.
VETERANS: Please call us at (215) 364-4247 to discuss your application.