You don’t have to travel miles for your child’s smile… Dental...
2
Dr. Louis LaTulippe 386.671.0404 for Infants, Children & Adolescents N O . . . Y E S ! ...CHILD DENIED DUE TO HEALTH REASONS ...DEDUCTIBLES ...ANNUAL MAXIMUMS ...WAITING PERIODS FREE PREVENTIVE CARE DISCOUNTS ON RESTORATIVE CARE AND OTHER SERVICES $19.95 / MONTH FOR THE 1 ST CHILD AND $14.95/MONTH FOR EACH ADDITIONAL CHILD MINIMUM ENROLLMENT PERIOD OF 12 MONTHS Miles of Smiles Pediatric Dentistry is the dental practice of Dr. Louis LaTulippe. Our office specializes in the oral health of children from infancy through their teenage years. We are conveniently located approximately one mile east of Interstate 95, off Exit 268 in Ormond Beach. You don’t have to travel miles for your child’s smile… SIGN UP TODAY FOR OUR LOW PRICED DENTAL PLAN! LOW-COST DENTAL PLAN Dr. Louis LaTulippe 6 Pearl Drive Ormond Beach, FL 32174 386.671.0404 www.milesofsmilesdmd.com
Transcript of You don’t have to travel miles for your child’s smile… Dental...
Dr. Louis LaTulippe386.671.0404
for Infants, Children & Adolescents
NO...
YES!
...Child denied due to health reasons...deduCtibles...annual MaxiMuMs...Waiting Periods
Free Preventive Care
Discounts on restorative Care and other serviCes
$19.95 / Month for the 1st Child and $14.95/Month for eaCh additional Childminimum enrollment perioD oF 12 months
Miles of Smiles Pediatric Dentistry is the
dental practice of Dr. Louis LaTulippe. Our
office specializes in the oral health of children
from infancy through their teenage years.
We are conveniently located approximately
one mile east of Interstate 95, off Exit 268
in Ormond Beach.
You don’t have to travel miles for your child’s smile… sign up todaY for our low priced dental plan!
low-cost Dental Plan
Dr. Louis LaTulippe 6 Pearl Drive Ormond Beach, FL 32174
386.671.0404
www.milesofsmilesdmd.com
Finally, dental coverage for your children you can afford!
Your children are invited to become members of the Miles of Smiles Wellness Plan!
For a small monthly membership fee, your children will be offered the preventive dental care they need at no cost! Other services they may need are also available for a minimal co-payment which are substantially less than the usual and customary fees.
Why wait? Begin your savings today by enrolling your child in the Miles of Smiles Wellness Program. Just complete the attached enrollment form and submit to Miles of Smiles Pediatric Dentistry, along with your credit card information.
FRee every 6 months
a value of $180.00 every 6 months FRee!
includes...
X-rays
Cleaning
Fluoride Treatment
Examination
Fillings Starting as low as $87.00
Extractions Starting as low as $95.00
Sealants: $38.00
PReVentIVe tReatMent
FIll Out thIs FORM tO staRt YOuR saVIngs tODaY!
RestORatIVe tReatMent
OtheR seRVICes
Any service not paid for at the time of service will be billed at our usual and customary rates.
All rates listed above are for Miles of Smiles Wellness Plan members only.
___________________________________________________FIRST NAME MIDDLE INITIAL LAST NAME
___________________________________________________STREET ADDRESS
___________________________________________________CITY STATE ZIP
___________________________________________________PHONE
___________________________________________________EMAIL
_______________________ _________________________DATE OF BIRTH SOCIAL SECURITY #
___________________________________________________VISA/MASTERCARD NUMBER
_______________ __________________________________EXPIRATION DATE SIGNATURE
___________________________________________________ENROLLMENT PERIOD
___________________________________________________FIRST NAME MIDDLE INITIAL LAST NAME
_______________________ _________________________DATE OF BIRTH RELATIONSHIP TO ENROLEE
___________________________________________________FIRST NAME MIDDLE INITIAL LAST NAME
_______________________ _________________________DATE OF BIRTH RELATIONSHIP TO ENROLEE
___________________________________________________FIRST NAME MIDDLE INITIAL LAST NAME
_______________________ _________________________DATE OF BIRTH RELATIONSHIP TO ENROLEE
Enrollee Information
Payment Information
Patient Information#1
#2
#3
It’s that easy!
minimum enrollment period of 12 monthsfrom to
