American Dental Plan offers continual "Open Enrollment". Just complete the form listed below, make sure to include your dental center selection and bank card information, and then click the SUBMIT button at the bottom of the page. We will reply to receiving your application and will mail your membership packet the next business day.
If you are renewing your current membership, you may also print and fax this renewal form to (480) 696-7189 or mail to:
American Dental Plan
P.O. Box 44227
Phoenix, AZ 85064
Make check payable to: American Dental Plan
Should you experience any difficulties, or wish to enroll by phone, please contact Customer Service, Mon-Fri, at (602) 265-6677, between 8:30 am and 3 pm MST