Smile Easy Dental Plan

Enjoy 2 Free Cleanings Per Year & Discounts Up To 30%

We offer an easy way for patients to receive comfortable, convenient care with the help of our in-house Smile Easy Dental Plan. It’s easy to get started – just fill out the application below and one of our associates will be in touch to finalize your membership!

Annual Premiums

$249 for first member
$179 each additional

Annual Benefits

2 Regular Cleanings (absence of periodontal disease)
If you receive periodontal therapy, you will receive one periodontal cleaning annually at no charge.(D4910/D4346/D4355)
2 Periodic Dental Exams
1 set of Check Up X-Rays & any individual X-rays needed throughout the year
30% Savings on Implant Placement (implants, abutments, attachments, bone grafts)
15% Savings on Invisalign
30% Savings on products – some exclusions may apply, call for details.
30% Savings on Fillings, Crowns, Veneers, Root Canals, Extractions, Dentures/Partials, Periodontal Treatment
30% Savings on in-office Boost Teeth Whitening

How much can you save?

Georgia Pricing – PDF Download
Michigan Pricing – PDF Download

Effective Date*
Date Format: MM slash DD slash YYYY
Preferred Office Location*
Member Name*
First Last
Address*
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Date of Birth*
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Email*
Home Phone*
Cell Phone*
Gender*
Number of Eligible Dependents*
Please enter a number from 0 to 6.
Have more than 6 eligible dependents? Please contact us for assistance.
Dependent 1 Name*
Dependent 1 Gender*
Dependent 1 Date of Birth*
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Dependent 2 Name*
Dependent 2 Gender*
Dependent 2 Date of Birth*
Date Format: MM slash DD slash YYYY
Dependent 3 Name*
Dependent 3 Gender*
Dependent 3 Date of Birth*
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Dependent 4 Name*
Dependent 4 Gender*
Dependent 4 Date of Birth*
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Dependent 5 Name*
Dependent 5 Gender*
Dependent 5 Date of Birth*
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Dependent 6 Name*
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Summary of Savings and Discounted Fees

Diagnostic & Preventative

ADA Code

Description of Services

Member Pays

Regular Price

Savings

0120

Periodic Oral Evaluation - Established Patient

No Charge

$60.00

0140

Limited oral evaluation- problem focused

No Charge

$95.00

0150

Comprehensive Oral Evaluation- new or established patient

No Charge

$101.00

0210

Full mouth x-rays

No Charge

$154.00

0220

First film

No Charge

$33.00

0230

Each additional film

No Charge

$30.00

0272

Bitewings- two films

No Charge

$53.00

0274

Bitewings - four films

No Charge

$75.00

0330

Panoramic Film

$91.00

$130.00

$39.00

1110

Prophylaxis (cleaning) adult

$105.00

$0.00

1120

Prophylaxis (cleaning) child

$80.00

$0.00

1206

Topical application of fluoride varnish

$17.50

$25.00

$7.50

1208

Topical application of fluoride

$31.50

$45.00

$13.50

1351

Sealant- per tooth

$44.10

$63.00

$18.90

Restorative - Fillings

ADA Code

Description of Services

Member Pays

Regular Price

Savings

2330

Composite- one surface, anterior

$137.90

$197.00

$59.10

2331

Composite- two surfaces, anterior

$167.30

$239.00

$71.70

2332

Composite- three surfaces, anterior

$203.70

$299.00

$95.30

2391

Composite- one surface, posterior

$149.10

$213.00

$63.90

2392

Composite- two surfaces, posterior

$189.00

$270.00

$81.00

2393

Composite- three surfaces, posterior

$231.00

$330.00

$99.00

Restorative - Crowns

ADA Code

Description of Services

Member Pays

Regular Price

Savings

2740

Crown-porcelain/ceramic substrate

$983.50

$1405.00

$421.50

2750

Crown-porcelain fused to high noble metal

$983.50

$1405.00

$421.50

2751

Crown-porcelain fused to base metal

$983.50

$1405.00

$421.50

2920

Recementation - crown

$91.70

$131.00

$39.30

2950

Core Buildup

$214.90

$307.00

$92.10

2954

Prefabricated post and core

$279.30

$399.00

$119.70

Endodontics - Root Canals

ADA Code

Description of Services

Member Pays

Regular Price

Savings

3310

Root Canal (anterior)

$735.00

$1050.00

$315.00

3320

Root Canal (bicuspid)

$809.20

$1156.00

$346.80

3330

Root Canal (molar)

$997.50

$1425.00

$427.50

Periodontics

ADA Code

Description of Services

Member Pays

Regular Price

Savings

4341

Periodontal scaling and root planing- 4 or more teeth per quadrant

$206.50

$295.00

$88.50

4355

Full mouth debridement

$193.90

$277.00

$83.10

4381

Localized delivery of antimicrobial agents

$56.70

$81.00

$24.30

4910

Periodontal maintenance

No Charge

$163.00

Prosthodontics - Dentures & Bridges

ADA Code

Description of Services

Member Pays

Regular Price

Savings

5110

Complete denture - maxillary (upper)

$1385.30

$1979.00

$593.70

5120

Complete denture- mandibular (lower)

$1385.30

$1979.00

$593.70

5213

Partial denture - maxillary (upper)

$1470.00

$2100.00

$630.00

5214

Partial denture - mandibular (lower)

$1536.50

$2195.00

$658.50

5225

Partial denture - flexible base- maxillary (upper)

$1050.00

$1500.00

$450.00

5226

Partial denture - flexible base- mandibular (upper)

$1050.00

$1500.00

$450.00

Bridge - Fixed

ADA Code

Description of Services

Member Pays

Regular Price

Savings

6240

Pontic-porcelain fused to high noble metal

$1186.50

$1695.00

$508.50

6241

Pontic-porcelain fused to base metal

$1186.50

$1695.00

$508.50

6245

Pontic-porcelain/ceramic

$1186.50

$1695.00

$508.50

6740

Crown-porcelain/ceramic

$910.70

$1301.00

$390.30

6750

Crown-porcelain fused to high noble metal

$1186.50

$1695.00

$508.50

Oral - Surgery

ADA Code

Description of Services

Member Pays

Regular Price

Savings

7140

Extraction, erupted tooth

$140.70

$201.00

$60.30

7210

Surgical removal of erupted tooth

$249.90

$357.00

$107.10

7220

Removal of impacted tooth- soft tissue

$270.90

$387.00

$116.10

7230

Removal of impacted tooth- partially bony

$341.60

$488.00

$146.40

7240

Removal of impacted tooth- completely bony

$397.60

$568.00

$170.40

Orthodontics

ADA Code

Description of Services

Member Pays

Regular Price

Savings

8090

Invisalign

$4696.00

$5870.00

$1174.00

Other Services

ADA Code

Description of Services

Member Pays

Regular Price

Savings

9910

Application of desensitizing resin

$51.80

$74.00

$22.20

9944/9945

Occlusal guard by report

$402.50

$575.00

$172.50