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We’re Making Excellence in Dentistry Affordable for You!
AffordableDental CoverageFor You & Your Entire Family
Hanover Road
Rid
geda
le A
venu
e
Columbia Turnpike
James Street
Midwood Drive
Shetland Road
Join The Art of Smile’s In-House Premier Dental Coverage
• All Members Receive 10% Discount on All Services
• All Health Conditions Accepted!
• You Cannot Be Denied Coverage!
• No Deductibles!
• No Health Questions!
• You Cannot Be Singled Out for Rate Increases or Cancellations!
• Comprehensive Exam (once every six months)
• Fluoride Treatment for Children (under the age of 18, once every six months)
Our Affordable Coverage Includes the Following Services at No Charge:
• X-Rays (once every 12 months)
• Cleaning (Prophylaxis) (once every six months)
Please List All UnmarriedChildren Up to Age 20
1. Child’s First Name _________________________ Middle Initial ______________ Son / Daughter Date of Birth ______________________________
2. Child’s First Name _________________________ Middle Initial ______________ Son / Daughter Date of Birth ______________________________
3. Child’s First Name _________________________ Middle Initial ______________ Son / Daughter Date of Birth ______________________________
4. Child’s First Name _________________________ Middle Initial ______________ Son / Daughter Date of Birth ______________________________
Complete This Form toBegin Coverage Today
Our office is located on Hanover Road, two blocks east of Columbia Turnpike.
ID# 5768 © August 2017 chrisad, inc., marin co., ca all rights reserved.
Enroll Today!
As Low as
$149/yr.
PERSONALIZED DENTAL CARE
PERSONALIZED DENTAL CARE
17 Hanover Road, Suite 230, Florham Park, NJ 07932
973-845-9955TheArtOfSmileDental.com
Low-Cost Dental CoverageAs Low as $149/yr.
PERSONALIZED DENTAL CARE
Make check or money order payable to The Art of Smile.
Call Us to Schedule Your Appointment Today!
Patients agree that The Art of Smile fees stated must be paid at the time services are rendered. Any service not paid for at the time of service will be billed at usual & customary fees. Coverage fees are valid only when paid at the time of enrollment. All family members must reside in the same household. This is not an insurance product.
First Name ________________________________________
Last Name ________________________________________
Middle Initial ________________________ Female / Male
Home Address _____________________________________
__________________________________________________
City _____________________ State ______ Zip ________
Phone ____________________________________________
Email _____________________________________________
Date of Birth _____/_____/_____
Spouse First Name __________________________________
Last Name ________________________________________
Middle Initial ________________________ Female / Male
Date of Birth _____/_____/_____
Enrollment Period _______________ to _______________
Signature (member & spouse)
__________________________________ Date ___________
__________________________________ Date ___________
American Express / Discover / MasterCard / Visa
Card Number ______________________________________
Expiration Date ____________________________________
Low-Cost Dental CoverageAll members receive
10% discount on services.• Individual ~ $149/yr.
• Individual & Spouse ~ $280/yr.
• Family Plan ~ $480/yr. (two adults & two kids)
• Additional Child in Family ~ $100/yr.
Now you can join our low-cost dental coverage for a nominal membership fee. Our coverage entitles you to preventive dental care at no cost! Corrective services are available for small co-payments that are far less than the usual, customary fees. Our professional staff is qualified to care for all of your dental needs!
To enroll, simply fill out the enclosed enrollment form & return it with your check, money order or credit card information. Please make check or money order payable to The Art of Smile.
Examination . . . . . . . . . . . . . . .No Charge . . . . . . . . . . $140
X-Rays (every 12 months) . . . . .No Charge . . . . . . . . . . . $73
4 Bitewing X-Rays . . . . . . . . . .No Charge . . . . . . . . . . . $65(every 12 months)
Adult Cleaning . . . . . . . . . . . .No Charge . . . . . . . . . . $130(every six months)
Children’s Cleaning . . . . . . . . .No Charge . . . . . . . . . . . $95(every six months)
Fluoride Treatment . . . . . . . . .No Charge . . . . . . . . . . . $65 for Children (every six months)
Preventive Dentistry
Service Co-Payment“Basic Care”
Regular Feesas High as
Periodontal Maintenance . . . . . . $141 . . . . . . . . . . . . $157
Periodontics
Service Co-Payment“Basic Care”
Regular Feesas High as
1-Surface Filling . . . . . . . . . . . . . . $175 . . . . . . . . . . . . $195
Crown . . . . . . . . . . . . . . . . . . . . . $1,224 . . . . . . . . . . . $1,360
Root Canal–Anterior . . . . . . . . . . $945 . . . . . . . . . . . $1,050
Denture (per arch) . . . . . . . . . . . $1,525 . . . . . . . . . . . $1,750
Restorative Dentistry
Service Co-Payment“Basic Care”
Regular Feesas High as
Cosmetic Whitening . . . . . . . . . . $315 . . . . . . . . . . . . $350
Other Treatments
Service Co-Payment“Basic Care”
Regular Feesas High as
Affordable Dental Coverage for the Whole Family!
PERSONALIZED DENTAL CARE
17 Hanover Road, Suite 230, Florham Park, NJ 07932
973-845-9955TheArtOfSmileDental.comInvisalign®. . . . . . . . . . . . Call for pricing due to personalization.
Night Guard . . . . . . . . . . . . . . . . . $405 . . . . . . . . . . . . $450
Orthodontics
Service Co-Payment“Basic Care”
Regular Feesas High as
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Please Inquire About Services Not Listed Here!
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