Physical Location:
2711 Irvin Way
Suite 111
Decatur, Georgia 30030

Phone: (404) 299-7700
Fax: (404) 299-7029

For more information,
please email:
dpg@dentalpartnersga.com

 
 
 

Membership Application

  1. To join Dental Partners of Georgia, LLC, please print the DPG Commitment Form.
    Click the above link to open the form in Microsoft Word.

    Mail the completed Commitment Form and Membership Fee to:
    Dental Partners of Georgia, LLC
    P.O. Box 71887
    Albany, GA 31708-1887
     
  2. Once DPG receives the completed Commitment Form, a complete Membership Packet will be mailed to you.  DPG individually credentials each Member through one of the following application processes:
  • CAQH: The CAQH Application System is used by the majority of managed care companies and benefits dentists because the application must only be completed one time. DPG will submit a request for you to complete a CAQH Online Application. Once you receive the invitation from CAQH, please visit the following site with your CAQH Provider ID to complete your application: https://upd.caqh.org/oas/.
     
  • Dental Partners of Georgia, LLC Application (Microsoft Word Document)
     
  • Georgia Standard Uniform Application Part I and Part II (Microsoft Word Documents)
     
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