CUSTOMER SERVICE REQUEST FOR THE DELTA DENTAL PREMIER AND DELTA DENTAL PPO PROGRAMS

     
 

We take every precaution to protect the confidentiality of your request, especially sensitive information such as social security numbers. For more information, see our Web privacy notice.

 
 
Required information to access records regarding your request
       
Enrollee First Name Patient First Name
Enrollee Last Name Patient Last Name
Enrollee ID Patient Date of Birth / / (mm/dd/yyyy)
Enrollee Date of Birth / / (mm/dd/yyyy)    
       
Explanation of request
 
 
E-mail Address    
 
       
       
   
       
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If you prefer to mail or telephone your inquiry, you can reach us at:

Customer Service
Delta Dental of California
P.O. Box 997330
Sacramento, CA 95899-7330
Toll-free
(888) 335-8227

       
 
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