Dental Insurance

Dr. Weller's office accepts a wide variety of dental insurance plans. Our knowledgeable office staff will work with your insurance company and help you estimate your benefits.

We must emphasize that as dental care providers our relationship is with you, not your insurance company. While the filing of insurance claims and checking on your benefits is a service that we extend to our patients, all charges are your responsibility from the date services are rendered.

Submit Your Insurance Information

If we have asked you to provide your insurance information, you may call the office or use this form. Please do not include your Social Security number!

All fields are required!

Patient Information
Name
Email Address
Phone Number
Insurance Company Information
Company Name
Phone Number
Address
Group/Policy #
Insurance ID #
Insured Person's Information
Relationship
Name
Birth Date
Employer

 

Payment Options

We accept all major credit cards, cash and checks. All treatment planned patients will be given a financial arrangement agreement that coordinates with your dental care.