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Become A SmileForm Member

At SmileForm, we aim to offer superb dental care at affordable costs. Whether you have limited or no insurance you receive premium preventive care, affordable rates, and much more when you become a member.

This membership can not be used with dental insurance or other dental plans or financing, and also excludes referral to specialists and hospitalizations. The plan is non-refundable, and does not roll over if not used within 12 months. Your bill is due day of service, and cannot be used with another plan.

Healthy mouth plan

$399/year

For patients 14+ years
  • 1 comprehensive exam
  • 1 periodic exam
  • 2 cleanings
  • 2 oral cancer screenings
  • 2 fluoride treatments
  • 1 set of full X-rays
  • 1 set of full intraoral photos
  • 1 limited exam with 1 X-ray (as needed)
  • 1 cosmetic consultation
  • 1 orthodontic consultation and oral hygiene instruction
  • 20% off all dental treatment

Periodontal plan

$599/year

For patients with periodontal disease
  • 1 comprehensive exam
  • 1 periodic exam
  • 4 periodontal maintenance cleanings
  • 2 oral cancer screenings
  • 2 fluoride treatments
  • 1 set of full X-rays
  • 1 set of full intraoral photos
  • 1 limited exam with 1 X-ray (as needed)
  • 1 cosmetic consultation
  • 1 orthodontic consultation and oral hygiene instruction
  • 20% off all dental treatment
  • 20% off 4 quad deep cleaning (as needed)

Healthy mouth kids

$199/year

For children under 14 years
  • 1 comprehensive exam
  • 1 periodic exam
  • 2 cleanings
  • 2 fluoride treatments
  • 1 set of full X-rays
  • 1 limited exam with 1 X-ray (as needed)
  • 1 orthodontic consultation and oral hygiene instruction
  • 20% off all dental treatment
meeting

More Reasons To Smile

Enjoy These Member Benefits

  • NO yearly maximums
  • NO deductibles
  • NO claim forms
  • NO pre-authorization requirements
  • NO pre-existing conditions limitations
  • NO one will be denied coverage
  • NO waiting periods

Planning Your First Visit To Our Office?

Take Advantage Of Our $125 Special

We love seeing new smiles! That’s why we’re offering all eligible new patients a $125 special offer that includes: 

  • Teeth Cleaning
  • X-Rays
  • Comprehensive Exam
  • And Much More!
dental x-ray

Don’t Delay Your Dental Needs

Discover Your True Smile

Book Now!
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