New Dentist Registration

New Dentist Registration

You must be an active dentist in practice no more than 5 years. You will be required to upload proof.

First
Last
Address
City
State/Province
Zip/Postal
Drop a file here or click to upload Choose File
Maximum upload size: 34.6MB
IF you are unable to upload a scanned or electronic version of your proof of your dental certificate, please email documents to sstone@ndaonline.org or fax to 240-297-9181.
Sending