Join
Thank you for your interest in joining LIBERTY Dental Plan’s distinguished provider network. Please take a few minutes to fill out the attached (
Facility Profile form) so that we know more about your facility. One of LIBERTY’s Network Managers will be contacting you directly once we receive your request.
Facility Profile form
Please send the completed form to LIBERTY Dental Plan using one of the following ways:
Email form to:
PRinquiries@libertydentalplan.com.jpg)
Mail form to:
Provider Relations
340 Commerce, Suite 100
Irvine, CA 92602
Fax form to:
(949) 270-1878