PARTICIPATING PROVIDER AGREEMENTParticipating Provider Agreement • July 30th, 2024
This Participating Provider Agreement (“Agreement”) is made and entered into this day of , (“Effective Date”), by and between (“Dentist”) and Dominion Dental Services, Inc., on behalf of itself and its applicable affiliates (“Plan”). Whenever mentioned herein, the term “Dentist” shall include all employees and agents of Dentist, including all partners, dentists, dental associates, and all staff personnel under Dentist’s direct supervision and/or control. Dentist and Plan may hereinafter be referred to individually as a “Party” and collectively as the “Parties.” The Regulatory Compliance Addendum attached to this Agreement as Exhibit A is expressly incorporated into this Agreement and is binding upon the Parties to this Agreement. In the event of any inconsistent or contrary language between the Regulatory Compliance Addendum and any other part of this Agreement, including but not limited to exhibits, attachments or amendments, the Parties agree that the provisions of the Regulatory Com