Provider resources

Would you like to communicate electronically?

Please provide your email address so that we can communicate with you electronically when appropriate.

Provider's email

Office email

Practice name*

Provider name*

Facility address*

*Field is required.

Have you grown your practice?

For new associates or locations, please complete this form so we can contact you to gather additional details.

Practice name*

First name*

Last name*

Best time to call*

Phone number

Please use the following format including hyphens: xxx-xxx-xxxx

Provider's email

Please use a valid email address

Office email

Please use a valid email address

*Field is required.

Dental Health Alliance®, L.L.C. (DHA) is a member of the Sun Life Financial, Inc. group of companies.

SLPC 27722 08/22 (exp. 08/24)

Canada