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Access Dental Plan (Individual), 12835 E. Arapahoe Rd Tower 1 Suite 830 Centennial, CO 80112
Phone: (303) 649-9311     Fax: (303) 649-9036     Toll Free: 1 (866) 870-6399

Membership Information

General Dentist
Dr. Mata (Arvada)
Dr. Riegel (Arvada)
Wesminster Dental Health (Arvada)
Bright Now! (Arvada)
Family and Implant Dentistry (Arvada)
Ault Family Dentistry (Ault)
Li'l Teeth Dentistry/Salida Smiles (Aurora)
Windsor Dental Care (Aurora)
Comfort Dental (Aurora)
Dr. Kinder (Aurora)
Alameda Dental (Aurora)
Tower Road (Aurora)
Open and Affordable Dental (Aurora)
Hanu Dental Care (Aurora)
Dr. Joo (Aurora)
Dr. Andy Lee (Aurora)
Dr. Terrance Wohlbaum (Aurora)
Dr. Fahmy (Aurora)
Comfort Dental (Aurora)
Cherokee Trail (Aurora)
Forest Hills Dental Care (Aurora)
Prospect Ave. (Aurora)
Dr. Gryzick (Aurora)
Dr. Bentley (Aurora)
Open and Affordable Dental (Bennett)
Dental Health of Boulder (Boulder)
Family and Implant Dentistry (Boulder)
Dr. Daniel (Boulder)
Prairie Center Dental Care (Brighton)
Open and Affordable Dental (Brighton)
Riverdale Dental (Brighton)
Mountain View Family Dental (Brighton)
Platte River (Brighton)
Dr. Berry (Broomfield)
Broomfield Dental Group (Broomfield)
Dr. Marogil (Broomfield)
Dr. Feeley (Broomfield)
Amherst Park Family Dental (Broomfield)
Broadlands Family Dentistry (Broomfield)
Castle Rock Dental Group (Castle Rock)
Bright Now! (Castle Rock)
Vogl Dental Arts (Castle Rock)
Dr. Houser (Castle Rock)
Shadow Rock (Castle Rock)
Cedar Mountain (Castle Rock)
Smoky Hill Family Dental (Centennial)
High Country Dental (Centennial)
Heather Park Dental Care (Centennial)
Comfort Dental (Centennial)
Dr. Michael Miller (Centennial)
Dr. Case (Centennial)
Orchard Dental (Centennial)
Dr. Hudec (Centennial)
Dr. Myers (Centennial)
Dr. Rowe (Centennial)
Dr. Christ (Centennial)
Sarah Meyer, DDS (Centennial)
University Park Dental (Centennial)
Dr. Brower (Colorado Springs)
Dr. Rodriguez (Colorado Springs)
Sayers Dental (Colorado Springs)
Cheyenne Mountain (Colorado Springs)
Bright Now! (Colorado Springs)
Bright Now! (Colorado Springs)
Jade Dental Professionals (Colorado Springs)
Dr. Camerino (Colorado Springs)
North Summit Dental (Colorado Springs)
Reunion Dental Care (Commerce City)
E. 62nd Ave. (Commerce City)
Dr. Braud (Commerce City)
Dr. Rinaldi (Commerce City)
Comfort Dental (Commerce City)
Comfort Dental (Conifer)
Dental Health 16th St. (Denver)
Bright Now! (Denver)
ATA Dental Center (Denver)
Dr. Paini (Denver)
Auraria Dental Oasis (Denver)
Dr. Moore (Denver)
Dr. Quandt (Denver)
Dr. Collis Johnson (Denver)
Capitol Hill Dental Group (Denver)
Dr. Huskey (Denver)
Dr. Sakamaki (Denver)
Sloan's Lake Dentistry (Denver)
Dr. Schlagel (Newton St.) (Denver)
Dental Health at Midtown (Denver)
Denver Family Dental (Denver)
Dr. Coombs (Denver)
Dr. Wachuta (Denver)
Dr. Madden (Denver)
Accord Dental (Denver)
Dr. Kye Lee (Denver)
Greentree (Denver)
Comfort Dental (Denver)
Hampden Family Dental (Denver)
Dental Health at the DTC (Denver)
Dr. Dougherty (Denver)
Dr. Pyne (Denver)
Dr. Johnston (Denver)
Ian Topelson, DMD (Denver)
L.M. Kuljis DDS (Englewood)
Dr. Shank (Englewood)
Comfort Dental (Englewood)
Dr. Bodoni (Englewood)
DaSilva Family Dentistry (Englewood)
Vista Ridge Dental Care (Erie)
Firestone Dental Care (Firestone)
Dr. Miller (Foxfield)
Dr. Marogil (Frederick)
Bright Now! (Ft. Collins)
Dr. Johnson (Ft. Collins)
Dr. Buxton (Ft. Collins)
Boardwalk Dental (Ft. Collins)
Dr. Murphy (Ft. Collins)
Dr. Allen (Ft. Collins)
Clear Creek (Ft. Collins)
Dr. Losacco (Georgetown)
Dr. Topelson (Glendale)
Dr. Wachuta (Golden)
Golden View (Golden)
Comfort Dental (Grand Junction )
Dr. Brown (Greeley)
Dr. Thorne (Greeley)
Dr. Jamison (Greeley)
Elena Bodoni DDS (Greenwood Village)
William Case DMD (Greenwood Village)
Rock Canyon Dental (Highlands Ranch)
Bright Now! (Highlands Ranch)
Open and Affordable Dental (Hudson)
Dr. Bender (LaSalle)
Dr. White (Lafayette)
Family and Implant Dentistry (Lafayette)
Dr. Winnicki (Lafayette)
New Day Dentistry (Lakewood)
Bright Now! (Lakewood)
Comfort Dental (Lakewood)
Dr. Milausnic (Lakewood)
Dr. Chavez (Lakewood)
Dr. Caldwell (Lakewood)
Dr. Paswaters (Lakewood)
Dr. Schroeder (Lakewood)
Dr. Wise (Lakewood)
Old Town (Littleton)
Rocky View Dental Care (Littleton)
Guaranteed Smiles (Littleton)
Dr. Kempton (Littleton)
Dr. Lampert (Littleton)
Clement Park Dental Care (Littleton)
Dr. Furini (Littleton)
Southwest Dental Care (Littleton)
Littleton Dental (Littleton)
Belleview Dental (Littleton)
Dr. Carlile (Littleton)
Dutch Creek (Littleton)
Gentle Dental of Lone Tree (Lone Tree)
Dr. Ambida (Lone Tree)
Dr. Craig Larson (Longmont)
Dr. Megan Murray (Longmont)
Bright Now! (Longmont)
Hover St (Longmont)
Mata Dental (Loveland)
Jackson Creek Dental Care (Monument)
Comfort Dental (Monument)
Dr. Niles (Niwot)
Dr. Ziegler (Northglenn)
Alpha Dental North (Northglenn)
Trail View Dental Care (Parker)
Bright Now! (Parker)
Dr. Roberts (Pueblo)
Dr. Villalon (Pueblo)
Dr. Saunders (Pueblo)
Dr. Graves (Pueblo)
Hilltop Dental Care (Thornton)
Barron Family Dental (Thornton)
Bright Now! (Thornton)
Eppinger Blvd. (Thornton)
Wesminster Dental Health (Westminster)
Westminster Dental Arts (Westminster)
Bright Now! (Westminster)
Aspen Hill Dental (Wheat Ridge)
Dr. Wachuta (Wheat Ridge)
Dr. Bruhin (Windsor)
Windsor Dental (Windsor)
New Patient

Member Information
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Birth Date
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Spouse Information
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Has Dental
Dental Type

Additional Dependent Information
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Referred By

Payment of Membership Fees
Upon completion of this form, you will have the option to pay your Membership Fees using your credit card via a secure payment portal. If you choose to pay by credit card, you will receive an email confirmation of payment. If you prefer, you may mail your payment to Comprehensive Healthcare Options, 12835 E. Arapahoe Rd., Tower 1, Suite 830, Centennial CO 80112. Your membership is activated on the day we process your payment.

I wish to become a member of the Access Dental Plan. I understand the limitations, exclusions and requirements of the plan. I understand that the Access Dental Plan is not insurance. I agree to pay any and all costs in collecting all charges, including but not limited to attorney fees and court costs. I understand membership must be continuous; that membership is on an annual basis; and I may terminate coverage on any anniversary of my enrollment. I understand all fees for services are payable when the services are rendered. I understand that I am eligible for a full refund of membership fees within 30 days of purchasing the Access Dental Plan. I understand that, as a result of cancellation of this plan, my dentist will retroactively bill me for the difference in the amount payable under the plan and his/her services I received while I was a participant of the plan. I understand that participating providers, fees for services and membership fees may change periodically. I certify all information on this form is true.
Acceptance (Please type "Accept" to accept the terms of this application)