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Join the network where millions of members are waiting to access your practice.

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Does your practice reside in any of the states below?

If you are in a state that uses mandated credentialing forms, your state is requiring you to use their form.

Step 1: Download your state's form by clicking the state name below.

Mandated CAQH Applications

Step 2: Download and fill out the Connection Dental Attestation form.

Step 3: Click this link to download the participating provider agreement.

Step 4: Collect any additional documents needed that are listed in your application.

Step 5: Visit our Contact page to obtain contact information for your state network representative. You can also fax your completed forms and documents to: (816) 257-4439.

If your state wasn't listed above, please follow the steps below.

Step 1: Click this link to download the Connection Dental Network Application

Step 2: Click this link to download the participating provider agreement.

Step 3: Collect any additional documents needed that are listed in your application.

Step 4: Visit our Contact page to obtain contact information for your state network representative. You can also fax your completed forms and documents to: (816) 257-4439.