Preferred Provider List
If your dentist is not on the list and you would like us to approach the provider, please print out and complete the Dentist Nomination Form below and mail it in to:
DentalSource Dental Plan, Inc.
1804 Juan Tabo NE, Ste. A
Albuquerque, NM 87112
This file can only be viewed/printed in Adobe Acrobat Reader. If you do not have Adobe Acrobat Reader click on the following link.
If you would like to contact us to have a brochure mailed to you instead, feel free to contact us.