SELECT CHOICE Dental Plan

Transcription

1 SELECT CHOICE Dental Plan Employee Enrollment Packet (ADP/POS) or (Corporate Office)

2 Beta Health Association, Inc. Dental Plan Specialists since 1990 WHAT IS THE SELECT CHOICE DENTAL PLAN? The Select Choice Dental Plan allows each employee the choice of enrolling in either of two different network dental plans; the Alpha Dental Plan (ADP) or CarePOS Dental Plan (POS). There are in excess of 1,100 combined providers in Colorado and over 91,000 provider locations nationally who participate in either the Alpha or CarePOS Dental network. There are many advantages to this flexible arrangement. Select Choice Option #1 Option #2 Alpha Dental (ADP) Network Plan Network Plan with over 700 providers across Colorado CarePOS (POS) Network Plan with over 91,000 providers nationally See Network Dentist Only Lower Co-Pays No Forms to Complete Unlimited Services Orthodontics (Child & Adult) No Waiting No Pre-authorizations Cosmetic Dentistry Included Immediate Access for all Services Save approximately 65% overall off of the normal full fee See Network Dentist Only Higher Co-Pays No Forms to Complete Unlimited Services Orthodontics (Child & Adult) No Waiting No Pre-authorizations Cosmetic Dentistry Included Immediate Access for all Services Save approximately 20 to 60% overall off of the normal full fee Not available in all states (See map)

3 Option #1 and #2 Dental Plan Highlights Cosmetic dentistry included No waiting on any services Orthodontics (braces) discounted for children and adults No forms to complete No age limits for members No limit on visits No exclusions for dental health conditions No limits on access to discounts (use as much as you like each year) Guaranteed acceptance The following fee schedules represent the discounts we have arranged in advance with the General Dentists who are participating in the plan. Simply pay these amounts directly to your participating dentist at the time services are rendered it s that easy! There are no claim forms to complete.

4 Beta Health Network Providers WA 1,592 * OR 280 CA 22,720 NV 1,340 ID 50 UT 757 AZ 2,344 MT * 1 WY 2 CO 1,117 NM 217 ND 0 SD 1 NE 33 KS 52 OK 1,185 TX 9,345 MN 901 IA 112 MO 398 AR 15 LA 125 WI 340 MI 926 IL 1,295 MS 38 IN 1,688 TN 293 AL 77 KY 219 OH 1,932 GA 3,134 WV 12 PA 3,704 SC 40 VA 627 NC 220 VT * NH NY 6,558 ME 131 MA 1,326 RI 52 CT 544 NJ 5,508 DE 6 MD 1,135 DC - 72 HI 72 AK 0 FL 19,026 * Only dependents can enroll in these states. Employees residing in these states are not eligible for the CarePOS plan available through BHA. Total Locations: 91,744 (3 in Puerto Rico) Updated: May 16, 2011 Not all products are available in all states. Please visit for the most up-to-date provider listings and fee schedules.

5 Beta Health Association, Inc. Dental Fee Schedule Alpha Plan #19 and CarePOS Form 9110 ADA CODE DENTAL PROCEDURE/ADA CODE DESCRIPTION NORMAL FEE ALPHA PLAN #19 CarePOS PLAN Diagnostic Services (Exams and X-rays) 999 ROUTINE OFFICE VISIT $ 35 $ 5 20% discount 120 PERIODIC ORAL EVALUATION $ 53 NO COST $ LIMITED ORAL EVALUATION-PROBLEM FOCUSED $ 79 $ 15 $ COMPREHENSIVE ORAL EVALUATION-NEW OR ESTABLISHED PATIENT $ 97 $ 12 $ X-RAY INTRAORAL COMPLETE SERIES INC. BITEWINGS $ 134 $ 29 $ X-RAY INTRAORAL PERIAPICAL-FIRST FILM $ 31 $ 6 $ X-RAY INTRAORAL PERIAPICAL EACH ADDITIONAL FILM $ 26 $ 5 $ X-RAY INTRAORAL OCCLUSAL FILM $ 48 $ 5 $ X-RAY EXTRAORAL FIRST FILM $ 75 $ 5 $ X-RAY EXTRAORAL-EACH ADDITIONAL FILM $ 63 $ 5 $ X-RAY BITEWING-SINGLE FILM $ 31 NO COST $ X-RAY BITEWING-2 FILMS $ 48 NO COST $ X-RAY BITEWING-4 FILMS $ 68 NO COST $ X-RAY PANORAMIC FILM $ 116 $ 49 $ CEPHALOMETRIC FILM $ 137 $ 60 $ PULP VITALITY TEST $ 61 NO COST $ DIAGNOSTIC CASTS $ 122 $ 49 $ EMERGENCY VISIT (SAME DAY) $ 90 $ 25 20% discount Preventive Services (Cleanings) 1110 PROPHYLAXIS-ADULT CLEANING (EVERY 6 MONTHS) $ 96 $ 15 $ PROPHYLAXIS-CHILD CLEANING (EVERY 6 MONTHS) $ 72 $ 15 $ TOPICAL APPLICATION OF FLUORIDE NOT INCL/PROPHY-CHILD $ 39 $ 11 $ ORAL HYGIENE INSTRUCTIONS $ 63 NO COST $ SEALANT PER TOOTH $ 58 $ 12 $ SPACE MAINTAINER FIXED UNILATERAL $ 338 $ 173 $ SPACE MAINTAINER FIXED BILATERAL $ 461 $ 250 $ SPACE MAINTAINER-REMOVABLE-UNILATERAL $ 418 $ 213 $ SPACE MAINTAINER-REMOVABLE-BILATERAL $ 522 $ 246 $ RE-CEMENTATION OF SPACE MAINTAINER $ 90 $ 17 $ ADDITIONAL PROPHY (FOR PERIO MAINTENANCE) $ 96 $ 41 20% discount Restorative Services (Fillings, Crowns, Inlays and Onlays) 2140 AMALGAM-1 SURFACE (PRIMARY OR PERMANENT) $ 150 $ 33 $ AMALGAM-2 SURFACES (PRIMARY OR PERMANENT) $ 195 $ 44 $ AMALGAM-3 SURFACES (PRIMARY OR PERMANENT) $ 232 $ 54 $ AMALGAM-4 OR MORE SURFACES (PRIMARY OR PERMANENT) $ 272 $ 63 $ RESIN BASED COMPOSITE 1 SURFACE (ANTERIOR) $ 169 $ 45 $ RESIN BASED COMPOSITE 2 SURFACES (ANTERIOR) $ 212 $ 58 $ RESIN BASED COMPOSITE 3 SURFACES (ANTERIOR) $ 264 $ 77 $ RESIN 4 OR MORE SURFACES OR INVOLVING INCISAL ANGLE (ANTERIOR) $ 328 $ 124 $ RESIN BASED COMPOSITE CROWN ( ANTERIOR) $ 476 $ 262 $ RESIN BASED COMPOSITE ONE SURFACE (POSTERIOR) $ 188 $ 98 $ RESIN BASED COMPOSITE TWO SURFACE (POSTERIOR) $ 243 $ 135 $ RESIN BASED COMPOSITE THREE SURFACE (POSTERIOR) $ 305 $ 172 $ RESIN BASED COMPOSITE FOUR OR MORE SURFACES (POSTERIOR) $ 364 $ 188 $ 156 *2510 INLAY-METALLIC-ONE SURFACE $ 906 $ 299 $ 366 *2520 INLAY-METALLIC-TWO SURFACE $ 936 $ 309 $ 415 *2530 INLAY-METALLIC-THREE OR MORE SURFACES $ 991 $ 327 $ 478 *2542 ONLAY-METALLIC-TWO SURFACES $ 1,005 $ 332 $ 439 *2543 ONLAY-METALLIC-THREE SURFACES $ 1,037 $ 343 $ 491 *2544 ONLAY-METALLIC-FOUR OR MORE SURFACES $ 1,069 $ 352 $ 512 *2610 INLAY-PORCELAIN/CERAMIC-ONE SURFACE $ 965 $ 318 $ 431 *2650 INLAY-RESIN BASED COMPOSITE-ONE SURFACE $ 927 $ 306 $ 284 *2651 INLAY-RESIN BASED COMPOSITE-TWO SURFACES $ 952 $ 314 $ 337 *2652 INLAY-RESIN BASED COMPOSITE-THREE OR MORE SURFACES $ 993 $ 328 $ 355 *2710 CROWN-RESIN BASED COMPOSITE (INDIRECT) $ 963 $ 319 $ 227 *2720 CROWN-RESIN WITH HIGH NOBLE METAL $ 1,139 $ 375 $ 625 *2721 CROWN-RESIN WITH PREDOMINANTLY BASE METAL $ 1,032 $ 340 $ 584 *2722 CROWN RESIN WITH NOBLE METAL $ 1,048 $ 346 $ 597 *2740 CROWN PORCELAIN/CERAMIC SUBSTRATE $ 1,196 $ 395 $ 639 *2750 CROWN PORCELAIN FUSED TO HIGH NOBLE METAL $ 1,164 $ 384 $ 631 *2751 CROWN-PORCELAIN FUSED TO PREDOMINANTLY BASE METAL $ 1,054 $ 315 $ 589 *2752 CROWN-PORCELAIN FUSED TO NOBLE METAL $ 1,091 $ 370 $ 602 Current Dental Terminology American Dental Association Page 1

6 ADA CODE DENTAL PROCEDURE/ADA CODE DESCRIPTION NORMAL FEE ALPHA PLAN #19 CarePOS PLAN Restorative Services (Fillings, Crowns, Inlays and Onlays) Con't *2790 CROWN FULL CAST HIGH NOBLE METAL $ 1,154 $ 366 $ 608 *2791 CROWN FULL CAST PREDOMINANTLY BASE METAL $ 1,028 $ 318 $ 580 *2792 CROWN FULL CAST NOBLE METAL $ 1,058 $ 345 $ RECEMENT INLAY, ONLAY, OR PARTIAL COVERAGE RESTORATION $ 116 $ 15 $ RECEMENT CROWN $ 116 $ 31 $ PREFAB. STAINLESS STEEL CROWN-PRIMARY $ 291 $ 101 $ PREFAB STAINLESS STEEL CROWN-PERMANENT $ 355 $ 123 $ PREFAB. RESIN CROWN $ 376 $ 157 $ PREFAB. STAINLESS STEEL CROWN WITH RESIN WINDOW $ 398 $ 179 $ SEDATIVE FILLING $ 132 $ 37 $ CORE BUILDUP INCLUDING ANY PINS $ 292 $ 82 $ PIN RETENTION PER TOOTH IN ADD. TO RESTORATION $ 81 $ 23 $ POST & CORE IN ADDITION TO CROWN, INDIRECTLY FABRICATED $ 456 $ 134 $ PREFAB POST & CORE IN ADDITION TO CROWN $ 365 $ 107 $ POST REMOVAL (NOT IN CONJUNCTION WITH ENDODONTIC THERAPY) $ 317 $ 139 $ LABIAL VENEER RESIN LAMINATE (CHAIRSIDE) $ 714 $ 187 $ BLEACHING (PER ARCH) $ 270 $ % discount 2999 $125 ADDTL.CHARGE P/UNIT FOR MULTIPLE CROWN UNITS/COMPLEX REHABILITATION *This applies to the Alpha Dental Plan only: These co-payments do not include an allowable $151 lab fee (per unit). Doctors, please make sure that all members understand what their fees will be and what the savings are from your Usual and Customary fees. Temporary crowns are included with permanent crown preparation. Endodontic Services (Root Canals) 3110 PULP CAP DIRECT EXCLUDING FINAL RESTORATION $ 90 $ 26 $ PULP CAP INDIRECT EXCLUDING FINAL RESTORATION $ 93 $ 27 $ THERAPEUTIC PULPOTOMY EXCLUDING FINAL RESTORATION $ 218 $ 72 $ PULPAL THERAPY ANTERIOR, PRIMARY TOOTH EXCLUDING FINAL RESTORATION $ 328 $ 102 $ PULPAL THERAPY POSTERIOR, PRIMARY TOOTH EXCLUDING FINAL RESTORATION $ 370 $ 113 $ ENDODONTIC THERAPY, ANTERIOR TOOTH (EXCLUDING FINAL RESTORATION) $ 778 $ 275 $ ENDODONTIC THERAPY, BICUSPID TOOTH (EXCLUDING FINAL RESTORATION) $ 874 $ 320 $ ENDODONTIC THERAPY, MOLAR (EXCLUDING FINAL RESTORATION) $ 1,058 $ 400 $ APICOECTOMY/PERIRADICULAR SURGERY-ANTERIOR $ 741 $ 328 $ APICOECTOMY/PERIRADICULAR SURGERY-BICUSPID (FIRST ROOT) $ 805 $ 366 $ APICOECTOMY/PERIRADICULAR SURGERY-MOLAR (FIRST ROOT) $ 950 $ 424 $ APICOECTOMY/PERIRADICULAR SURGERY-EACH ADDITIONAL ROOT $ 450 $ 161 $ RETROGRADE FILLING-PER ROOT $ 315 $ 116 $ SURGICAL PROCEDURE FOR ISOLATION OF TOOTH WITH RUBBER DAM $ 279 $ 64 $ 71 Periodontic Services (Gum Disease) 4210 GINGIVOPLASY OR GIGIVECTOMY- 4+ CONTIGUOUS OR BOUNDED SP. TEETH P/QUAD $ 704 $ 333 $ GINGIVECTOMY OR GINGIVOPLASTY-1 TO 3 CONTIGUOUS OR BOUNDED SP. TEETH P/QUAD $ 323 $ 178 $ GINGIVAL FLAP PROCEDURE, INCL.ROOT PLNG -4+ CONTIG. OR BOUNDED SP. TEETH P/QUAD $ 820 $ 352 $ OSSEOUS SURG. INCL. FLAP ENTRY & CLOSURE-4+ CONTIG. OR BOUNDED SP. TEETH P/QUAD $ 1,138 $ 521 $ PROVISIONAL SPLINTING-INTRACORONAL $ 556 $ 260 $ PROVISIONAL SPLINTING-EXTRACORONAL $ 527 $ 246 $ PERIODONTAL SCALING & ROOT PLNG- 4+ TEETH PER QUAD $ 265 $ 112 $ FULL MOUTH DEBRIDEMENT TO ENABLE COMP.EVAL. & DIAGNOSIS $ 197 $ 89 $ PERIODONTAL MAINTENANCE $ 146 $ 57 $ PERIO SCREENING AND SCORING $ 30 $ 10 20% discount Prosthodontics (Removable/Complete Dentures, etc.) 5110 COMPLETE DENTURE-MAXILLARY $ 1,799 $ 533 $ COMPLETE DENTURE-MANDIBULAR $ 1,799 $ 533 $ IMMEDIATE DENTURE-MAXILLARY $ 1,921 $ 764 $ IMMEDIATE DENTURE-MANDIBULAR $ 1,958 $ 778 $ MAXILLARY PART. DENTURE-RESIN BASE (INCL. CLASPS, RESTS & TEETH) $ 1,474 $ 463 $ MANDIBULAR PARTIAL DENTURE-RESIN BASE (INCL. CLASPS, RESTS & TEETH) $ 1,448 $ 442 $ MAXILLARY PART. DENT.-CST MTL FRMEWRK W/RESIN DENT. BASE (INCL/CLASPS, RESTS & TEETH) $ 1,885 $ 547 $ MANDIBULAR PART. DENT.-CST MTL FRMEWRK W/RESIN DENT. BASE (INCL/CLASPS, RESTS & TEETH) $ 1,889 $ 545 $ ADJUST COMPLETE DENTURE-MAXILLARY $ 96 $ 36 $ ADJUST COMPLETE DENTURE-MANDIBULAR $ 95 $ 36 $ ADJUST PARTIAL DENTURE-MAXILLARY $ 95 $ 36 $ ADJUST PARTIAL DENTURE-MANDIBULAR $ 95 $ 36 $ REPAIR BROKEN COMPLETE DENTURE BASE $ 231 $ 88 $ REPLACE MISSING OR BROKEN TEETH-COMPLETE DENTURE-EACH TOOTH $ 197 $ 62 $ REPAIR RESIN DENTURE BASE $ 225 $ 82 $ REPAIR CAST FRAMEWORK $ 313 $ 139 $ REPAIR OR REPLACE BROKEN CLASP $ 286 $ 105 $ REPLACE BROKEN TEETH-PER TOOTH $ 198 $ 68 $ ADD TOOTH TO EXISTING PARTIAL DENTURE $ 241 $ 93 $ ADD CLASP TO EXISTING PARTIAL DENTURE $ 292 $ 121 $ 138 Current Dental Terminology American Dental Association Page 2

7 ADA CODE DENTAL PROCEDURE/ADA CODE DESCRIPTION NORMAL FEE ALPHA PLAN #19 CarePOS PLAN Prosthodontics (Removable/ Complete Dentures, etc.) Con't 5710 REBASE COMPLETE MAXILLARY DENTURE $ 630 $ 276 $ REBASE COMPLETE MANDIBULAR DENTURE $ 629 $ 276 $ REBASE MAXILLARY PARTIAL DENTURE $ 609 $ 230 $ REBASE MANDIBULAR PARTIAL DENTURE $ 609 $ 231 $ RELINE COMPLETE MAXILLARY DENTURE (CHAIRSIDE) $ 402 $ 175 $ RELINE COMPLETE MANDIBULAR DENTURE (CHAIRSIDE) $ 402 $ 175 $ RELINE MAXILLARY PARTIAL DENTURE (CHAIRSIDE) $ 397 $ 167 $ RELINE MANDIBULAR PARTIAL DENTURE (CHAIRSIDE) $ 402 $ 167 $ RELINE COMPLETE MAXILLARY DENTURE (LABORATORY) $ 503 $ 155 $ RELINE COMPLETE MANDIBULAR DENTURE (LABORATORY) $ 503 $ 155 $ RELINE MAXILLARY PARTIAL DENTURE (LABORATORY) $ 503 $ 158 $ RELINE MANDIBULAR PARTIAL DENTURE (LABORATORY) $ 503 $ 157 $ TISSUE CONDITIONING MAXILLARY $ 231 $ 66 $ TISSUE CONDITIONING MANDIBULAR $ 233 $ 65 $ 80 NOTE: For the Alpha Dental Plan only, the fees listed above in section 5000 thru 6000, additional fees may be charged for upgraded teeth and enhanced cosmetics, personalization beyond norm or techniques involving precision dentures. Prosthodontics (fixed/partial Dentures, etc.) *6210 PONTIC-CAST HIGH NOBLE METAL $ 1,133 $ 359 $ 553 *6211 PONTIC-CAST PREDOMINANTLY BASE METAL $ 1,037 $ 303 $ 517 *6212 PONTIC-CAST NOBLE METAL $ 1,075 $ 320 $ 538 *6240 PONTIC-PORCELAIN FUSED TO HIGH NOBLE METAL $ 1,161 $ 383 $ 545 *6241 PONTIC-PORCELAIN FUSED TO PREDOMINANTLY BASE METAL $ 1,058 $ 312 $ 504 *6242 PONTIC-PORCELAIN FUSED TO NOBLE METAL $ 1,084 $ 331 $ 531 *6250 PONTIC-RESIN WITH HIGH NOBLE METAL $ 1,085 $ 345 $ 538 *6251 PONTIC-RESIN WITH PREDOMINANTLY BASE METAL $ 1,042 $ 323 $ 497 *6252 PONTIC-RESIN WITH NOBLE METAL $ 1,044 $ 325 $ 512 *6720 CROWN-RESIN WITH HIGH NOBLE METAL $ 1,154 $ 380 $ 607 *6721 CROWN-RESIN WITH PREDOMINANTLY BASE METAL $ 1,042 $ 344 $ 577 *6722 CROWN-RESIN WITH NOBLE METAL $ 1,067 $ 352 $ 586 *6750 CROWN-PORCELAIN FUSED TO HIGH NOBLE METAL $ 1,164 $ 384 $ 622 *6751 CROWN-PORCELAIN FUSED TO PREDOMINANTLY BASE METAL $ 1,052 $ 315 $ 581 *6752 CROWN-PORCELAIN FUSED TO NOBLE METAL $ 1,079 $ 335 $ 594 *6790 CROWN-FULL CAST HIGH NOBLE METAL $ 1,133 $ 359 $ 602 *6791 CROWN-FULL CAST PREDOMINANTLY BASE METAL $ 1,042 $ 323 $ 569 *6792 CROWN-FULL CAST NOBLE METAL $ 1,084 $ 330 $ RECEMENT FIXED PARTIAL DENTURE $ 185 $ 69 $ 72 *This applies to the Alpha Dental Plan only: These co-payments do not include an allowable $151 lab fee (per unit). Doctors, please make sure that all members understand what their fees will be and what the savings are from your Usual and Customary fee. Oral Surgery (Extractions, etc.) 7140 EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORCEPS REMOVAL) $ 185 $ 46 $ SURGICAL REMOVAL ERUPTED TOOTH WITH REMOVAL OF BONE AND/OR SECTION OF TOOTH $ 295 $ 81 $ REMOVAL OF IMPACTED TOOTH-SOFT TISSUE $ 345 $ 92 $ REMOVAL OF IMPACTED TOOTH PARTIALLY BONY $ 419 $ 163 $ REMOVAL OF IMPACTED TOOTH-COMPLETELY BONY $ 524 $ 210 $ REMOVAL OF IMPACTED TOOTH-COMPLETELY BONY W/ UNUSUAL SURG. COMPLICATION $ 635 $ 248 $ SURGICAL REMOVAL OF RESIDUAL TOOTH ROOTS (CUTTING PROCEDURE) $ 322 $ 118 $ TOOTH REIMPL. AND/OR STAB. OF ACC.EVULSED OR DISPL. TOOTH $ 609 $ 243 $ SURGICAL ACCESS OF AN UNERUPTED TOOTH $ 540 $ 235 $ BIOPSY OF ORAL TISSUE-HARD (BONE-TOOTH) $ 497 $ 217 $ BIOPSY OF ORAL TISSUE-SOFT $ 344 $ 150 $ ALVEOPLASTY IN CONJ. WITH EXT.4 OR MORE TEETH OR TOOTH SPACES PER QUAD $ 329 $ 126 $ ALVEOPLASTY NOT IN CONJ WITH EXT. 4 OR MORE TEETH OR TOOTH SPACES PER QUAD $ 528 $ 195 $ INCISION AND DRAINAGE ABSCESS- INTRAORAL SOFT TISSUE $ 255 $ 99 $ SUTURE OF RECENT SMALL WOUNDS UP TO 5CM $ 341 NO COST $ FRENULECTOMY (FRENECTOMY OR FRENOTOMY)- SEPARATE PROCEDURE $ 498 $ 128 $ EXCISION OF HYPERPLASTIC TISSUE- PER ARCH $ 582 $ 207 $ 341 General Miscellaneous Services 9110 PALLIATIVE (EMERGENCY) TREATMENT OF DENTAL PAIN- MINOR PROCEDURE $ 138 $ 48 $ ANALGESIA, ANXIOLYSIS, INHALATION OF NITROUS OXIDE - FIRST 30 MINUTES $ 95 $ 27 $ CONSULTATION (DIAG. SERV. PROV. BY DENTIST OR PHYSICIAN OTHER THAN PRACTIONER PROV. TREATMNT) $ 159 NO COST $ APPLICATION OF DESENSITIZING MEDICAMENT $ 73 $ 6 $ FABRICATION OF ATHLETIC MOUTHGUARD $ 315 $ 107 $ OCCLUSAL ADJUSTMENT-LIMITED $ 212 $ 77 $ OCCLUSAL ADJUSTMENT-COMPLETE $ 770 $ 286 $ MISSED APPOINTMENT (WITHOUT 24 HOUR NOTICE) $ 54 $ 30 20% discount Current Dental Terminology American Dental Association Page 3

8 ADA CODE DENTAL PROCEDURE/ADA CODE DESCRIPTION (Alpha Dental Plan ONLY) NORMAL FEE ALPHA PLAN #19 CarePOS PLAN Orthodontics (Braces) for Children & Adults Alpha Monthly Payment Alpha 13 MONTH TREATMENT PLAN ($137/MONTH) $ 3,114 $ 2,409 20% discount Alpha 16 MONTH TREATMENT PLAN ($137/MONTH) $ 3,625 $ 2,820 20% discount Alpha 19 MONTH TREATMENT PLAN ($137/MONTH) $ 4,135 $ 3,231 20% discount Alpha 22 MONTH TREATMENT PLAN ($137/MONTH) $ 4,606 $ 3,642 20% discount Alpha 25 MONTH TREATMENT PLAN ($137/MONTH) $ 5,158 $ 4,053 20% discount Alpha 28 MONTH TREATMENT PLAN ($137/MONTH) $ 5,669 $ 4,464 20% discount Alpha 31 MONTH TREATMENT PLAN ($137/MONTH) $ 6,179 $ 4,875 20% discount Alpha 34 MONTH TREATMENT PLAN ($137/MONTH) $ 6,690 $ 5,286 20% discount Alpha 36 MONTH TREATMENT PLAN ($137/MONTH) $ 6,951 $ 5,560 20% discount Other Orthodontic Guidelines (These Orthodontic guidelines apply to the Alpha Dental Plan only) 1. A $382 charge will apply at the end of treatment (included in the above amounts) to cover all retention office visits (unlimited). 2. Services not listed above will be discounted 30% off of the participating Orthodontist's Usual and Customary fees (except #5 listed below). 3. Services must only be provided by a contracted Orthodontic Specialist. 4. The amounts listed above also include an initial one-time $246 charge for all records, mold, x-rays, etc. to determine the Orthodontic Treatment for the patient. 5. Invisalign procedures are to be discounted 15% off the participating Orthodontist's Usual and Customary fees. Alpha Dental Plan General Limitations and Exclusions 1. All fees listed above do not include all appropriate lab fees. Member must agree (in writing) to all upgraded materials before treatment is started. See each section for specific details (if applicable). 2. All patients are responsible for paying all fees (as listed above) at the time services are rendered. 3. These fees are for General Dentists only. A participating specialist list is available by calling our office at or Any procedures not listed will be discounted 20% off the participating General Dentists normal fees. 5. Medical costs associated with any dental procedures are not covered. 6. Dentures or appliances will be replaced only after 3 years have elapsed since such dentures or appliances were provided under any plan program, unless the denture or appliance becomes unserviceable due to illness or other causes not controlled by other means. Replacement of dentures, appliances, or bridgework due to loss or theft are not covered. 7. Any dental treatment started prior to the Member's eligibility to receive services under this plan or started after a Member's termination are not covered. 8. Failure to follow the prescribed treatment or accidents occurring during the course of treatment may result in additional charges by your plan provider. 9. Failure to pay scheduled fees at the time service is rendered may prevent future dental services from being received until all fees have been paid in full. 10. Services provided by non-participating dentists are not covered. 11. Services which, in the opinion of the attending dentist, are not necessary for the patient's dental health, or are contrary to established dental ethics are not covered. 12. Cosmetic dental procedures are covered only if the attending dentist and patient agree on the specific procedure. 13. Services which are compensable under Worker's Compensation or employer liability laws are not covered. 14. General anesthesia and IV sedation are not covered. 15. Myofunctional therapy procedure for training, treating or developing muscles in and around the jaw or mouth including TMJ are not covered except by participating plan specialists. 16. Any dental procedure or service that cannot be performed in the dental office due to general and/or physical limitations of a member are not covered. 17. Expenses incurred for dental procedures initiated prior to member's eligibility or after termination are not covered. 18. Any services that the Participating General Dentist recommends be performed by a specialist are covered only by a plan participating specialist. 19. The liability of Beta Health Association, Inc. is limited to the return of the membership fees paid for one year by the member. 20. Extractions for asymptomatic third molars (wisdom teeth) are not covered unless causing movement of the teeth. An example of symptomatic include severe decay, and ontogenic cysts, chronic pericoronitis, and infection. 21. The Beta Health Association, Inc. dental programs do not constitute dental insurance and are considered discount, fee-forservice dental plans. 22. Fees are subject to change on an as needed basis. Please contact Beta Health Association, Inc. for current fees. CarePOS Plan General Limitations This is a discount program. This is not an insurance plan. Careington cannot guarantee specialty care in all areas. In cases in which you are referred to a participating specialist, you will generally receive 15% to 20% off their usual and customary fees. Please verify such benefits with each individual provider. Work in progress, after joining the plan, must be completed by the provider who started the work. Any procedures performed by a non participating provider are not included. Careington International cannot guarantee the continued participation of any provider. If he or she leaves the plan, you will need to select another provider. Not all types of providers may be available in your area. Some providers may charge for missed or broken appointments if no prior notice is given. It is the member s responsibility to verify that the provider is a participating provider. This plan does not include all procedures which might be provided. Any procedure delivered which is not listed on the Schedule of Services may cause additional cost to be incurred by the member. The dollar amount specified adjacent to each procedure may not be the only cost incurred for a given treatment because the treatment may require more than one procedure. Note to Utah Residents: This contract is not protected by the Utah Life and Health Guaranty Association. The program and the program administrators have no liability for providing or guaranteeing service and have no liability for the quality of service rendered. The most widely used dental procedures, discounted fees and limitations are illustrated. Please contact Beta Health Association, Inc. at (303) or with any questions. Current Dental Terminology American Dental Association Page 4

9 Complete Participating Provider Directory (Alpha and Beta CarePOS Dental Plan) Plan providers are listed in alphabetical order according to city. The most up to date provider listings can be found at You can also call or for assistance. All dentists listed are accepting new patients. Contact the office directly if you wish to verify. General Dentists Dr. Richard Williams Dr. Richard Williams ADP # Edison Alamosa General Dentist *, **, C, E1-2, E3-4, N Dr. Alan Bueltel Comfort Dental - Arvada ADP # W 64th Ave Arvada General Dentist *, C, E1-2, E3-4 Dr. Alex R Roberts Arvada Modern Dentistry CarePOS W 64th Ave Unit C Arvada General Dentist Dr. Allan G Skromme Dental Health Of Westminster (General Dentists) CarePOS 7970 Sheridan Blvd Fl Arvada General Dentist Dr. Amir A Hashemi Dental Health Of Westminster (General Dentists) CarePOS 7970 Sheridan Blvd Fl Arvada General Dentist Dr. Bahar Esmaili Dental Health Of Westminster (General Dentists) CarePOS 7970 Sheridan Blvd Fl Arvada General Dentist Dr. Brian Elliott Dental Health Of Westminster (General Dentists) CarePOS 7970 Sheridan Blvd Fl Arvada General Dentist Dr. Charles F Rodgers Arvada Modern Dentistry CarePOS W 64th Ave Unit C Arvada General Dentist Dr. David A Zeitlin David A. Zeitlin ADP # W 88th Ave Arvada General Dentist *, C, E1-2, E3-4 Dr. Donald Langley Dental Health Of Westminster (General Dentists) CarePOS 7970 Sheridan Blvd Fl Arvada General Dentist Dr. Duane R Mata Supreme Dental, Mata Dental Associates CarePOS 5310 Ward Rd Arvada General Dentist Dr. Dwayne A Moore Dental Health Of Westminster (General Dentists) CarePOS 7970 Sheridan Blvd Fl Arvada General Dentist Dr. Jack C Moss Dental Health Of Westminster (General Dentists) CarePOS 7970 Sheridan Blvd Fl Arvada General Dentist Dr. James R Mayo Comfort Dental - Arvada ADP # W 64th Ave Arvada General Dentist *, C, E1-2, E3-4 Dr. Joanne L Bancroft Dental Health Of Westminster (General Dentists) CarePOS 7970 Sheridan Blvd Fl Arvada General Dentist Dr. John A Short Dental Health Of Westminster (General Dentists) CarePOS 7970 Sheridan Blvd Fl Arvada General Dentist Dr. Juan Materon Comfort Dental - North Arvada ADP # W 80th Ave Arvada General Dentist *, **, C, E1-2, E3-4 Dr. Julia T Kasper Arvada Modern Dentistry CarePOS W 64th Ave Unit C Arvada General Dentist Dr. Kathy Tomlinson Comfort Dental - North Arvada ADP # W 80th Ave Arvada General Dentist *, **, C, E1-2, E3-4 Dr. Kelsey E Majors Arvada Modern Dentistry CarePOS W 64th Ave Unit C Arvada General Dentist Dr. Lawrence D Yahnian Dental Health Of Westminster (General Dentists) CarePOS 7970 Sheridan Blvd Fl Arvada General Dentist Dr. Marina Varshavskaya Comfort Dental - North Arvada ADP # W 80th Ave Arvada General Dentist *, **, C, E1-2, E3-4 Dr. Mark Dean Comfort Dental - Arvada ADP # W 64th Ave Arvada General Dentist *, C, E1-2, E3-4 Dr. Metodi A Milushev Dental Health Of Westminster (General Dentists) CarePOS 7970 Sheridan Blvd Fl Arvada General Dentist Dr. Neil Zimmet Comfort Dental - Arvada ADP # W 64th Ave Arvada General Dentist *, C, E1-2, E3-4 Dr. Shayna Bahr Comfort Dental - North Arvada ADP # W 80th Ave Arvada General Dentist *, **, C, E1-2, E3-4 Dr. Stephen M Perry Dental Health Of Westminster (General Dentists) CarePOS 7970 Sheridan Blvd Fl Arvada General Dentist Dr. Tjark R Beaven Arvada Modern Dentistry CarePOS W 64th Ave Unit C Arvada General Dentist Dr. Bradley W Eckhardt Ault Family Dentistry CarePOS 120 N 2nd St Ault General Dentist Dr. Amir A Hashemi Dental Heath At Center Pointe CarePOS E Alameda Ave Aurora General Dentist Dr. Amir R Fereydouni Kid'S & Family Dentistry CarePOS 1344 S Chambers Rd Ste Aurora General Dentist Dr. Asha Chinni Comfort Dental - Orchard Rd. ADP # E Orchard Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Dr. Ashleigh S Harrison Cornerstar Dental Group And Orthodontics CarePOS 6730 S Cornerstar Way Ste A Aurora General Dentist Dr. Bahar Esmaili Dental Heath At Center Pointe CarePOS E Alameda Ave Aurora General Dentist Page 1 of 21

10 Dr. Barry Wohlgemuth Wohlgemuth & Rush, DDS ADP # S Parker Rd # Aurora General Dentist C, N Dr. Benjamin T Dyches Havana Square Family Dental CarePOS 1977 S Havana St Aurora General Dentist Dr. Bradford J O'Neill Cornerstar Dental Group And Orthodontics CarePOS 6730 S Cornerstar Way Ste A Aurora General Dentist Dr. Brian A Ozenbaugh Cornerstar Dental Group And Orthodontics CarePOS 6730 S Cornerstar Way Ste A Aurora General Dentist Dr. Brian Kajewski Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. Charles F Rodgers City Place Modern Dentistry CarePOS E Bayaud Ave Unit H Aurora General Dentist Dr. Charles F Rodgers Aurora Modern Dististry CarePOS Garden Dr Ste Aurora General Dentist Dr. Charles F Rodgers Cornerstar Dental Group And Orthodontics CarePOS 6730 S Cornerstar Way Ste A Aurora General Dentist Dr. Charles F Rodgers Valley Modern Dentists CarePOS E Quincy Ave Ste B Aurora General Dentist Dr. Charles Woyda Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. Charles Woyda Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. Christopher Bentley Grandview Dental ADP # S Liverpool St #-A Aurora General Dentist **, C, E1-2, E3-4 Dr. Christopher Bentley Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. Christopher M Cannon Comfort Dental Tower & Iliff CarePOS E Iliff Ave Ste A & B Aurora General Dentist Dr. Clyde A Bowden Clyde A. Bowden ADP # E Alameda Ave Aurora General Dentist C, E1-2, N Dr. Cory M Johnston Valley Modern Dentists CarePOS E Quincy Ave Ste B Aurora General Dentist Dr. Craig A Mellor Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. Craig A Mellor Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. Daegan B Orr Comfort Dental Aurora CarePOS 1050 S Peoria St Aurora General Dentist Dr. Davood Manshadi Kids Choice Dental Of Aurora PC CarePOS E Colfax Ave Unit B Aurora General Dentist Dr. Douglas P Price Comfort Dental Aurora CarePOS 1050 S Peoria St Aurora General Dentist Dr. Dwayne A Moore Chambers Point Dental Care Pllc CarePOS 1700 S Chambers Rd Aurora General Dentist Dr. Dwayne A Moore Dental Heath At Center Pointe CarePOS E Alameda Ave Aurora General Dentist Dr. Ekapoj Thongin Comfort Dental Tower & Iliff CarePOS E Iliff Ave Ste A & B Aurora General Dentist Dr. Ekatrina Butkevich Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. Ekatrina Butkevich Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. Erin M Deedy-Lee City Place Modern Dentistry CarePOS E Bayaud Ave Unit H Aurora General Dentist Dr. Erin M Deedy-Lee Aurora Modern Dististry CarePOS Garden Dr Ste Aurora General Dentist Dr. Gerald Edwards Comfort Dental - Aurora ADP # S Peoria Aurora General Dentist *, **, C, E1-2, E3-4, N Dr. Henry D Ahn Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. Henry D Ahn Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. James A Fischer Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. James A Fischer Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. James Liu Comfort Dental - Quincy Buckley ADP # E Quincy D1-D Aurora General Dentist **, C, E1-2 Dr. Jeffrey A Varner Comfort Dental - East Aurora ADP # S Chambers Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Dr. Jeffrey Gilliam Comfort Dental-Havana ADP # E Colfax Ave # Aurora General Dentist *, **, C, E1-2, E3-4 Dr. Jeffrey Gilliam Comfort Dental - Aurora ADP # S Peoria Aurora General Dentist *, **, C, E1-2, E3-4, N Dr. Jeffrey Hamilton Comfort Dental - Orchard Rd. ADP # E Orchard Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Dr. Jennie C Brown Brookview Dental CarePOS 1344 S Chambers Rd Ste Aurora General Dentist Dr. Jennifer Parker Cornerstar Dental Group And Orthodontics CarePOS 6730 S Cornerstar Way Ste A Aurora General Dentist Dr. Jim Parfitt Comfort Dental - East Aurora ADP # S Chambers Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Dr. John C Harvan Southland Smiles CarePOS E Smoky Hill Rd Unit Aurora General Dentist Dr. John W Thousand, Iii Comfort Dental - Quincy Buckley ADP # E Quincy D1-D Aurora General Dentist **, C, E1-2 Dr. Joshua Hollingshead Comfort Dental - Orchard Rd. ADP # E Orchard Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Page 2 of 21

11 Dr. Julie Mankin Kid'S Dental CarePOS 2295 S Chambers Rd Ste E Aurora General Dentist Dr. Justin J Kwon Green Dental ADP # E Bethany Dr, # Aurora General Dentist *, **, C, E1-2, E3-4 Dr. Katherine T Johnson Cornerstar Dental Group And Orthodontics CarePOS 6730 S Cornerstar Way Ste A Aurora General Dentist Dr. Katie L Mccann Aurora Modern Dististry CarePOS Garden Dr Ste Aurora General Dentist Dr. Kris Komanduri Hanu Dental Care ADP # E Cornell Ave # Aurora General Dentist *, **, C, E1-2, E3-4 Dr. Kristina K Harvan Southland Smiles CarePOS E Smoky Hill Rd Unit Aurora General Dentist Dr. Lauren Peterson Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. Leigh A Stephens Cornerstar Dental Group And Orthodontics CarePOS 6730 S Cornerstar Way Ste A Aurora General Dentist Dr. Leigh A Stephens Valley Modern Dentists CarePOS E Quincy Ave Ste B Aurora General Dentist Dr. Malgorzata R Korosciel Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. Malgorzata R Korosciel Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. Manisha Patil Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. Manisha Patil Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. Marat Fainberg City Place Modern Dentistry CarePOS E Bayaud Ave Unit H Aurora General Dentist Dr. Mark N Lawson Village Park Dental P.C. CarePOS E Mississippi Ave Aurora General Dentist Dr. Matthew Rowan Comfort Dental - Aurora ADP # S Peoria Aurora General Dentist *, **, C, E1-2, E3-4, N Dr. Metodi A Milushev Dental Heath At Center Pointe CarePOS E Alameda Ave Aurora General Dentist Dr. Michael Chang Michal W Chang DDS PC CarePOS 1344 S Chambers Rd Ste Aurora General Dentist Dr. Michael Miller Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. Michael Millward Comfort Dental - Orchard Rd. ADP # E Orchard Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Dr. Mona Omran Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. Monica S Kahl Aurora Modern Dististry CarePOS Garden Dr Ste Aurora General Dentist Dr. Nelson S Joo Nelson S Joo CarePOS 2222 S Fraser St Unit Aurora General Dentist Dr. Richard Doerhoff Comfort Dental - East Aurora ADP # S Chambers Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Dr. Robert B Allen Comfort Dental Tower & Iliff CarePOS E Iliff Ave Ste A & B Aurora General Dentist Dr. Robert B Mcdonald Comfort Dental Tower & Iliff CarePOS E Iliff Ave Ste A & B Aurora General Dentist Dr. Roy Theriot Dr. Roy Theriot ADP # S Havana, # Aurora General Dentist *, C Dr. Semiramida Condoianis Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. Semiramida Condoianis Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. Stephen M Perry Dental Heath At Center Pointe CarePOS E Alameda Ave Aurora General Dentist Dr. Steven Rush Wohlgemuth & Rush, DDS ADP # S Parker Rd # Aurora General Dentist C, N Dr. Susan Kutis Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. Thomas E Daniel Dr. Thomas E. Daniel ADP # Havana Aurora General Dentist C Dr. Thomas Mulheran Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. Thomas Mulheran Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. Tiffany Fritz Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. Tiffany Fritz Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. Traver L Maxwell Comfort Dental - Quincy Buckley ADP # E Quincy D1-D Aurora General Dentist **, C, E1-2 Dr. Trevor Neal Aurora Modern Dististry CarePOS Garden Dr Ste Aurora General Dentist Dr. Vidhyalakshmi Sampath Bright Now Dental - S. Tower Rd. ADP # S Tower Rd, #c Aurora General Dentist *, **, C, E1-2 Dr. Vidhyalakshmi Sampath Bright Now Dental - Smoky Hill ADP # Prospect Ave, Ste #hv2be Aurora General Dentist *, C, E1-2, E3-4 Dr. Wade R Hirschman Cornerstar Dental Group And Orthodontics CarePOS 6730 S Cornerstar Way Ste A Aurora General Dentist Dr. Zachary D Bergeson Comfort Dental-Havana ADP # E Colfax Ave # Aurora General Dentist *, **, C, E1-2, E3-4 Dr. Zachary D Bergeson Comfort Dental - Aurora ADP # S Peoria Aurora General Dentist *, **, C, E1-2, E3-4, N Page 3 of 21

12 Dr. Allan G Skromme Dental Health Of Boulder, Pllc (General Dentists) CarePOS th St Unit Boulder General Dentist Dr. Amir A Hashemi Dental Health Of Boulder, Pllc (General Dentists) CarePOS th St Unit Boulder General Dentist Dr. Andrew Holecek Dental Health Of Boulder, Pllc (General Dentists) CarePOS th St Unit Boulder General Dentist Dr. Bahar Esmaili Bright Now Dental - Boulder ADP # Folsom St Boulder General Dentist *, C, E1-2, E3-4 Dr. Bahar Esmaili Dental Health Of Boulder, Pllc (General Dentists) CarePOS th St Unit Boulder General Dentist Dr. Brian Elliott Dental Health Of Boulder, Pllc (General Dentists) CarePOS th St Unit Boulder General Dentist Dr. Brian Kajewski Bright Now Dental - Boulder ADP # Folsom St Boulder General Dentist *, C, E1-2, E3-4 Dr. Craig A Mellor Bright Now Dental - Boulder ADP # Folsom St Boulder General Dentist *, C, E1-2, E3-4 Dr. Donald Langley Dental Health Of Boulder, Pllc (General Dentists) CarePOS th St Unit Boulder General Dentist Dr. Dwayne A Moore Dental Health Of Boulder, Pllc (General Dentists) CarePOS th St Unit Boulder General Dentist Dr. Geoffery Dilbert Bright Now Dental - Boulder ADP # Folsom St Boulder General Dentist *, C, E1-2, E3-4 Dr. Jack F Emmons Bright Now Dental - Boulder ADP # Folsom St Boulder General Dentist *, C, E1-2, E3-4 Dr. James A Fischer Bright Now Dental - Boulder ADP # Folsom St Boulder General Dentist *, C, E1-2, E3-4 Dr. John A Short Dental Health Of Boulder, Pllc (General Dentists) CarePOS th St Unit Boulder General Dentist Dr. Lawrence D Yahnian Dental Health Of Boulder, Pllc (General Dentists) CarePOS th St Unit Boulder General Dentist Dr. Lindsey Schroepfer Bright Now Dental - Boulder ADP # Folsom St Boulder General Dentist *, C, E1-2, E3-4 Dr. Lisa Sheldon Comfort Dental - Boulder ADP # Arapahoe Rd Boulder General Dentist *, C, E1-2, E3-4 Dr. Mariano De La Riva Bright Now Dental - Boulder ADP # Folsom St Boulder General Dentist *, C, E1-2, E3-4 Dr. Mark Cannon Comfort Dental - Boulder ADP # Arapahoe Rd Boulder General Dentist *, C, E1-2, E3-4 Dr. Mark Hook Dental Health Of Boulder, Pllc (General Dentists) CarePOS th St Unit Boulder General Dentist Dr. Metodi A Milushev Dental Health Of Boulder, Pllc (General Dentists) CarePOS th St Unit Boulder General Dentist Dr. Rochelle A Manangkil Boulder Modern Dentistry CarePOS th St Ste 4f Boulder General Dentist Dr. Sharon Poczatek Todays Choice Dental ADP # Valmont Rd Boulder General Dentist *, **, C, E1-2, E3-4 Dr. Stephen W Laycock Bear Peak Dental CarePOS 4150 Darley Ave Ste Boulder General Dentist Dr. Thomas Mulheran Bright Now Dental - Boulder ADP # Folsom St Boulder General Dentist *, C, E1-2, E3-4 Dr. William J Mcglashan Boulder Modern Dentistry CarePOS th St Ste 4f Boulder General Dentist Dr. Daniel R Anderson Comfort Dental CarePOS 315 E Bromley Ln Brighton General Dentist Dr. Dustin R Craven Brighton Dental Professional, LLC CarePOS 315 E Bromley Ln Brighton General Dentist Dr. John I Bethers Comfort Dental CarePOS 315 E Bromley Ln Brighton General Dentist Dr. John Schmidt Mountain View Family Dental CarePOS 2700 E Bridge St Ste Brighton General Dentist Dr. Pasco W Scarpella Platte River Family Dental, PC CarePOS 965 Platte River Blvd Unit E Brighton General Dentist Dr. Brian M Richter Broomfield Modern Dentistry And Orthontics CarePOS 4490 W 121st Ave Ste Broomfield General Dentist Dr. Charles F Rodgers Broomfield Modern Dentistry And Orthontics CarePOS 4490 W 121st Ave Ste Broomfield General Dentist Dr. Katherine T Johnson Broomfield Modern Dentistry And Orthontics CarePOS 4490 W 121st Ave Ste Broomfield General Dentist Dr. Lyndon Mata Mata Dental ADP # W 120th Ave, # Broomfield General Dentist *, C, E1-2, N Dr. William J Mcglashan Broomfield Modern Dentistry And Orthontics CarePOS 4490 W 121st Ave Ste Broomfield General Dentist Dr. Thomas Jorgensen Brush Dental CarePOS 412 Edison St Brush General Dentist Dr. Gregory E Micheli Shadow Hills Dental Clinic ADP # Forest Ave Canon City General Dentist *, C, E1-2, E3-4 Dr. Charles Woyda Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Dr. Christopher Bentley Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Dr. Craig A Mellor Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Dr. David T Sugiyama Cedar Mountain Family Dentistry CarePOS 1189 S Perry St Ste Castle Rock General Dentist Dr. Ekatrina Butkevich Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Dr. Henry D Ahn Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Page 4 of 21

13 Dr. James A Fischer Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Dr. Jennifer Parker Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Dr. Malgorzata R Korosciel Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Dr. Manisha Patil Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Dr. Michael Miller Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Dr. Semiramida Condoianis Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Dr. Susan Kutis Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Dr. Thomas Mulheran Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Dr. Tiffany Fritz Bright Now Dental - Castle Rock ADP # S Perry St, #105-A Castle Rock General Dentist *, C, E1-2, E3-4 Dr. Vikash Kanchanlal Shadow Rock Dentistry ADP # Wilcox St # Castle Rock General Dentist *, **, C, E1-2, E3-4 Dr. Brittany Bevis 1st Choice Dental CarePOS 6979 S Holly Cir Ste Centennial General Dentist Dr. Camillo Di Liza Dental Dry Creek CarePOS 7960 S University Blvd Ste Centennial General Dentist Dr. Charles F Rodgers Southglenn Modern Dentistry CarePOS 2330 E Arapahoe Rd Ste Centennial General Dentist Dr. Christine M Isaacs Aloha Family & Cosmetic Dentistry CarePOS 8170 S University Blvd Ste Centennial General Dentist Dr. David W Lindman Comfort Dental - Centennial ADP # S Quebec St, Unit A Centennial General Dentist *, C, E1-2, E3-4 Dr. Derrick Q Price Comfort Dental - Centennial ADP # S Quebec St, Unit A Centennial General Dentist *, C, E1-2, E3-4 Dr. Donald Langley Southglenn Modern Dentistry CarePOS 2330 E Arapahoe Rd Ste Centennial General Dentist Dr. Eric M Wolfe Holly Dental Associates, L.L.C. CarePOS 8010 S Holly St Ste Centennial General Dentist Dr. Jennifer L Manske Blue Mesa Dental CarePOS 8100 S Quebec St #stea Centennial General Dentist Dr. Kevin M Christ Kevin M Christ DMD PC CarePOS 9025 E Mineral Cir Ste Centennial General Dentist Dr. Kevin Marshall Comfort Dental - Centennial ADP # S Quebec St, Unit A Centennial General Dentist *, C, E1-2, E3-4 Dr. Kurt E Nielsen Holly Dental Associates, L.L.C. CarePOS 8010 S Holly St Ste Centennial General Dentist Dr. Landis C Scholes Holly Dental Associates, L.L.C. CarePOS 8010 S Holly St Ste Centennial General Dentist Dr. Luis J Bravo Luis J Bravo, DMD CarePOS 6650 S Vine St Ste Centennial General Dentist Dr. Margarita Aleksanyan Guaranteed Smiles - Southglenn ADP # E Easter Ave, # Centennial General Dentist C, E1-2, E3-4 Dr. Michael S Peppler 1st Choice Dental CarePOS 6979 S Holly Cir Ste Centennial General Dentist Dr. Murray Jacobs Comfort Dental - Centennial ADP # S Quebec St, Unit A Centennial General Dentist *, C, E1-2, E3-4 Dr. Neal K Wilsted A-Dent Neal K. Wilsted CarePOS 7920 S University Blvd Ste Centennial General Dentist Dr. Patricia M Nicolosi Patricia M Nicolosi, PC CarePOS 5161 E Arapahoe Rd Centennial General Dentist Dr. Sarah J Meyer Sarah J. Meyer DDS ADP # S Vine St Centennial General Dentist *, C Dr. Tiffany N Manzo Southglenn Modern Dentistry CarePOS 2330 E Arapahoe Rd Ste Centennial General Dentist Dr. William Case Dr. William Case ADP # E Orchard Rd, # Centennial General Dentist *, C Dr. Zahra Nadji Nadji Dental Inc CarePOS 6979 S Holly Cir Ste Centennial General Dentist Dr. Angelo M Camerino North Summit Dental Care ADP # Jet Stream Dr # Colorado Springs General Dentist *, C, E1-2, E3-4 Dr. Arnold Cullum Colorado Springs Dental Service Dba Lowell District Dental CarePOS 251 E Fountain Blvd Unit Colorado Springs General Dentist Dr. Arnold Cullum PC Colorado Springs Dental Services CarePOS 685 Citadel Dr E Ste Colorado Springs General Dentist Dr. Benjamin Weir Comfort Dental-South Powers ADP # Space Center Dr # Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Brian A Buccellato Falcon Landing Dental Group And Orthodontics CarePOS 7395 N Academy Blvd Colorado Springs General Dentist Dr. Brian Anderson Comfort Dental - Citadel Crossing ADP # N Academy Blvd Colorado Springs General Dentist *, C, E1-2 Dr. Carolyn T Camerino Centennial Dental Care PC. ADP # Silverstone Terr # Colorado Springs General Dentist *, C, E1-2, E3-4 Dr. Charles F Rodgers Falcon Landing Dental Group And Orthodontics CarePOS 7395 N Academy Blvd Colorado Springs General Dentist Dr. Charles F Rodgers Prominent Point Dental Group And Orthodontics CarePOS 9625 Prominent Pt Ste Colorado Springs General Dentist Dr. Charles F Rodgers The Springs Modern Dentistry CarePOS 5198 N Nevada Ave Ste Colorado Springs General Dentist Dr. Christian Lovejoy Comfort Dental - North Powers ADP # Stetson Hills Blvd Colorado Springs General Dentist *, **, C, E1-2, E3-4 Page 5 of 21

14 Dr. Craig A Mellor Bright Now Dental - Citadel Dr. ADP # Citadel Dr East Colorado Springs General Dentist **, C, E1-2, E3-4, N Dr. Craig A Mellor Bright Now Dental - Parkmoor Village ADP # N Academy Blvd, # Colorado Springs General Dentist C, E1-2, E3-4 Dr. Dan Kingsford Comfort Dental - Austin Bluffs ADP # A North Academy Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Daniel L Ward Stafford Dental Group ADP # E Pikes Peak Ave, # Colorado Springs General Dentist **, E1-2, E3-4 Dr. Deepali Verma Verma Cosmetic And Family Dentistry CarePOS 511 Security Blvd Colorado Springs General Dentist Dr. Douglas Peak All Smiles Orthodontix CarePOS 3715 Bloomington St Unit Colorado Springs General Dentist Dr. Dustin B Dial Comfort Dental - North Powers ADP # Stetson Hills Blvd Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Dwight Bratton Castillo Dental Associates PC CarePOS 1910 Vindicator Dr Ste Colorado Springs General Dentist Dr. Dwight Douglas Olson My Dental Company ADP # E Cheyenne Mountain Blvd # Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Grant Mack Comfort Dental - Citadel Crossing ADP # N Academy Blvd Colorado Springs General Dentist *, C, E1-2 Dr. Gregory R Smith Colorado Dental Group CarePOS 3236 Centennial Blvd Colorado Springs General Dentist Dr. James Kalhorn Stafford Dental Group ADP # E Pikes Peak Ave, # Colorado Springs General Dentist **, E1-2, E3-4 Dr. Jamison Miller Comfort Dental - North Powers ADP # Stetson Hills Blvd Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Jay Johnson Comfort Dental-South Powers ADP # Space Center Dr # Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Jeremy Bullock Comfort Dental - Austin Bluffs ADP # A North Academy Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Joshua Bevans Comfort Dental - North Powers ADP # Stetson Hills Blvd Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Julia A Rohleder Dr Norma M Longo PC DDS CarePOS Gleneagle Dr Ste Colorado Springs General Dentist Dr. Julia Arnold Interquest Dental Group, Inc. ADP # United Heights Dr # Colorado Springs General Dentist C Dr. Kathleen Brower Jade/erindale Dental ADP # Erin Park Dr Colorado Springs General Dentist C, E1-2, E3-4 Dr. Kathleen Brower Rigby Dental PC ADP # N Academy Blvd # Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Kelly A Halligan Dr Norma M Longo PC DDS CarePOS Gleneagle Dr Ste Colorado Springs General Dentist Dr. Kristi A Davies Dr Norma M Longo PC DDS CarePOS Gleneagle Dr Ste Colorado Springs General Dentist Dr. Leopoldo Rodríguez Rigby Dental PC ADP # N Academy Blvd # Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Linda A Eaton Prominent Point Dental Group And Orthodontics CarePOS 9625 Prominent Pt Ste Colorado Springs General Dentist Dr. Matthew A Lovato Matthew Lovato DDS Pllc CarePOS 3233 W Carefree Cir Bldg G Colorado Springs General Dentist Dr. Matthew S Loeppke Prominent Point Dental Group And Orthodontics CarePOS 9625 Prominent Pt Ste Colorado Springs General Dentist Dr. Michael G Jacobs Comfort Dental - Citadel Crossing ADP # N Academy Blvd Colorado Springs General Dentist *, C, E1-2 Dr. Michael Miller Bright Now Dental - Citadel Dr. ADP # Citadel Dr East Colorado Springs General Dentist **, C, E1-2, E3-4, N Dr. Michael Miller Bright Now Dental - Parkmoor Village ADP # N Academy Blvd, # Colorado Springs General Dentist C, E1-2, E3-4 Dr. Michael Stoor Comfort Dental - Citadel Crossing ADP # N Academy Blvd Colorado Springs General Dentist *, C, E1-2 Dr. Natalie Jones Comfort Dental - North Academy ADP # York Rd Colorado Springs General Dentist *, C, E1-2, E3-4 Dr. Nathan Budge Comfort Dental-South Powers ADP # Space Center Dr # Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Nelson C Krum Prominent Point Dental Group And Orthodontics CarePOS 9625 Prominent Pt Ste Colorado Springs General Dentist Dr. Nicole R Hartmann Prominent Point Dental Group And Orthodontics CarePOS 9625 Prominent Pt Ste Colorado Springs General Dentist Dr. Nicole R Hartmann The Springs Modern Dentistry CarePOS 5198 N Nevada Ave Ste Colorado Springs General Dentist Dr. Norma Longo Dr Norma M. Longo DMD PC CarePOS Gleneagle Dr Ste Colorado Springs General Dentist Dr. Orlando J Lucero O J Lucero DDS PC CarePOS 1855 Austin Bluffs Pkwy Ste A Colorado Springs General Dentist Dr. Patrick Hudson Comfort Dental - Austin Bluffs ADP # A North Academy Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Paul F Hastings Norma Longo & Assoc CarePOS Gleneagle Dr Ste Colorado Springs General Dentist Dr. Paul Hennegan Bright Now Dental - Parkmoor Village ADP # N Academy Blvd, # Colorado Springs General Dentist C, E1-2, E3-4 Dr. Paul Rodríguez Dr. Paul Rodríguez ADP # N Tejon St, #d Colorado Springs General Dentist **, C, E1-2, E3-4 Dr. Paul Rygg Jade/erindale Dental ADP # Erin Park Dr Colorado Springs General Dentist C, E1-2, E3-4 Dr. Paul Rygg Rigby Dental PC ADP # N Academy Blvd # Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Paul Rygg Jade Dental Associates ADP # N Tejon St, #a Colorado Springs General Dentist C, E1-2, E3-4 Page 6 of 21

15 Dr. Peter Lovejoy Comfort Dental - North Academy ADP # York Rd Colorado Springs General Dentist *, C, E1-2, E3-4 Dr. Philip B Holden Philip B. Holden, DDS CarePOS 620 Southpointe Ct Ste Colorado Springs General Dentist Dr. Quynh Dung V Sosdian Uptown Dental Associates CarePOS 523 N Nevada Ave Colorado Springs General Dentist Dr. Richard H Wiedey Dr. Richard H. Wiedey ADP # North Circle # Colorado Springs General Dentist **, E1-2, E3-4, N Dr. Robert B Wyeth Comfort Dental - North Academy ADP # York Rd Colorado Springs General Dentist *, C, E1-2, E3-4 Dr. Stephen G Sosdian Uptown Dental Associates CarePOS 523 N Nevada Ave Colorado Springs General Dentist Dr. Ted L Rigby Rigby Dental PC ADP # N Academy Blvd # Colorado Springs General Dentist *, **, C, E1-2, E3-4 Dr. Thomas Mulheran Bright Now Dental - Citadel Dr. ADP # Citadel Dr East Colorado Springs General Dentist **, C, E1-2, E3-4, N Dr. Thomas Mulheran Bright Now Dental - Parkmoor Village ADP # N Academy Blvd, # Colorado Springs General Dentist C, E1-2, E3-4 Dr. Timothy J Byrnes Prominent Point Dental Group And Orthodontics CarePOS 9625 Prominent Pt Ste Colorado Springs General Dentist Dr. Timothy J Byrnes The Springs Modern Dentistry CarePOS 5198 N Nevada Ave Ste Colorado Springs General Dentist Dr. Travis L Edwards Comfort Dental - Citadel Crossing ADP # N Academy Blvd Colorado Springs General Dentist *, C, E1-2 Dr. Tyler J Pickett The Springs Modern Dentistry CarePOS 5198 N Nevada Ave Ste Colorado Springs General Dentist Dr. Mark A Karla Commerce City Family Dental CarePOS 4972 E 62nd Ave Unit B Commerce City General Dentist Dr. Owen Eames Comfort Dental -Commerce City ADP # Monaco St Commerce City General Dentist *, **, C, E1-2, E3-4 Dr. Rachel Ross Comfort Dental -Commerce City ADP # Monaco St Commerce City General Dentist *, **, C, E1-2, E3-4 Dr. Ramsey Warner Comfort Dental -Commerce City ADP # Monaco St Commerce City General Dentist *, **, C, E1-2, E3-4 Dr. Christopher J Higuchi Aspen Park Dental CarePOS Conifer Rd Conifer General Dentist Dr. Jacqueline Blasko Comfort Dental-Conifer ADP # Conifer Rd Conifer General Dentist *, **, C, E1-2, E3-4 Dr. Jason Mahoney Comfort Dental-Conifer ADP # Conifer Rd Conifer General Dentist *, **, C, E1-2, E3-4 Dr. Teniel Seifert Comfort Dental-Conifer ADP # Conifer Rd Conifer General Dentist *, **, C, E1-2, E3-4 Dr. Alan Coombs Alpha Dental Ii, PC ADP # S Albion, # Denver General Dentist ** Dr. Allan G Skromme Dental Health At 16th Street Mall, Pllc (General Dentists) CarePOS 1600 Stout St Ste Denver General Dentist Dr. Allan G Skromme Dental Health Of Dtc CarePOS 5031 S Ulster St Ste Denver General Dentist Dr. Allan G Skromme Dental Health At Midtown Pllc CarePOS 2005 Franklin St Bldg 2 Ste Denver General Dentist Dr. Amir A Hashemi Dental Health At 16th Street Mall, Pllc (General Dentists) CarePOS 1600 Stout St Ste Denver General Dentist Dr. Amir A Hashemi Dental Health Of Dtc CarePOS 5031 S Ulster St Ste Denver General Dentist Dr. Amir A Hashemi Dental Health At Midtown Pllc CarePOS 2005 Franklin St Bldg 2 Ste Denver General Dentist Dr. Arnold Cullum Blake Street Dental PC CarePOS 1732 Blake St Denver General Dentist Dr. Ashleigh S Harrison University Hills Modern Dentistry CarePOS 2466 S Colorado Blvd Unit Denver General Dentist Dr. Aurora Saddler Comfort Dental Of S.E. Denver CarePOS 3488 S Willow St Denver General Dentist Dr. Bahar Esmaili Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. Bahar Esmaili Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Bahar Esmaili Dental Health At 16th Street Mall, Pllc (General Dentists) CarePOS 1600 Stout St Ste Denver General Dentist Dr. Bahar Esmaili Dental Health Of Dtc CarePOS 5031 S Ulster St Ste Denver General Dentist Dr. Bahar Esmaili Dental Health At Midtown Pllc CarePOS 2005 Franklin St Bldg 2 Ste Denver General Dentist Dr. Brandon C Hall Riverfront Dental Designs CarePOS 1590 Little Raven St Ste Denver General Dentist Dr. Brian Elliott Dental Health At 16th Street Mall, Pllc (General Dentists) CarePOS 1600 Stout St Ste Denver General Dentist Dr. Brian Elliott Dental Health Of Dtc CarePOS 5031 S Ulster St Ste Denver General Dentist Dr. Brian Elliott Dental Health At Midtown Pllc CarePOS 2005 Franklin St Bldg 2 Ste Denver General Dentist Dr. Brian Kajewski Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. Brian Kajewski Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Brianna J Sweeney Dental Health At 16th Street Mall, Pllc (General Dentists) CarePOS 1600 Stout St Ste Denver General Dentist Dr. Buhm J Sohn C.S. Family Dental CarePOS 6825 E Hampden Ave Ste Denver General Dentist Page 7 of 21

16 Dr. Chad Welch Southeast Denver Dental Associates ADP # S Monaco Pkwy Denver General Dentist *, **, C, E1-2, E3-4 Dr. Charles P Mccary Hampden Family Dentistry & Orthodontics CarePOS 9250 E Hampden Ave Denver General Dentist Dr. Charles Woyda Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Chelsea R Deutscher Wynkoop Dental CarePOS 1401 Wynkoop St Ste Denver General Dentist Dr. Christopher Bentley Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. Christopher Bentley Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Collis Johnson Family Dentistry CarePOS 1756 Vine St Denver General Dentist Dr. Craig A Mellor Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. Craig A Mellor Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Dale Roberts Dental Health Of Dtc CarePOS 5031 S Ulster St Ste Denver General Dentist Dr. David Dinsmore Comfort Dental - Cherry Creek ADP # University Blvd, # Denver General Dentist *, C, E1-2, E3-4 Dr. David Koo Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. David R Huskey David R. Huskey, DDS ADP # S Downing, #104 A Denver General Dentist C, E1-2, N Dr. Donald Connor Alpha Dental Care 1 CarePOS 6411 E Colfax Ave Denver General Dentist Dr. Donald Langley Dental Health At 16th Street Mall, Pllc (General Dentists) CarePOS 1600 Stout St Ste Denver General Dentist Dr. Donald Langley Dental Health Of Dtc CarePOS 5031 S Ulster St Ste Denver General Dentist Dr. Donald Langley Dental Health At Midtown Pllc CarePOS 2005 Franklin St Bldg 2 Ste Denver General Dentist Dr. Donald Mardis Comfort Dental - East Colfax ADP # E Colfax Ave Denver General Dentist *, **, C, E1-2 Dr. Douglas R Koch Greentree Dental ADP # E Hampden Ave # Denver General Dentist *, **, C, E1-2, E3-4 Dr. Dwayne A Moore Dental Health At 16th Street Mall, Pllc (General Dentists) CarePOS 1600 Stout St Ste Denver General Dentist Dr. Dwayne A Moore Dental Health Of Dtc CarePOS 5031 S Ulster St Ste Denver General Dentist Dr. Ekatrina Butkevich Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. Ekatrina Butkevich Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Gary Rotolo Comfort Dental - East Colfax ADP # E Colfax Ave Denver General Dentist *, **, C, E1-2 Dr. Gary Saddler Comfort Dental - North Denver ADP # W 38th Ave # Denver General Dentist *, **, C, E1-2, E3-4 Dr. Gilbert Sandoval Sandoval Family Dentistry CarePOS 4515 E Colfax Ave Denver General Dentist Dr. Hanh H Phi Hampden Family Dentistry & Orthodontics CarePOS 9250 E Hampden Ave Denver General Dentist Dr. Heather A Sturdivant Hampden Family Dentistry & Orthodontics CarePOS 9250 E Hampden Ave Denver General Dentist Dr. Henry D Ahn Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. Henry D Ahn Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Jack F Emmons Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. James A Fischer Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. James A Fischer Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Janice Jones Southeast Denver Dental Associates ADP # S Monaco Pkwy Denver General Dentist *, **, C, E1-2, E3-4 Dr. Jason N Whiting Green Valley Ranch Cosmetic & Family Dental CarePOS 4809 Argonne St Ste Denver General Dentist Dr. Jason Ray Hampden Family Dental ADP # E Hampden Ave #-A Denver General Dentist *, **, C, E1-2, E3-4 Dr. Jeff D Johnston Ascent Dental Group CarePOS 3600 E Alameda Ave Ste Denver General Dentist Dr. Jennifer L Speer Comfort Dental - South Denver CarePOS 3488 S Willow St Denver General Dentist Dr. Jennifer S Terada Dr Jennifer Terada CarePOS 825 E 18th Ave Denver General Dentist Dr. Joesolyn Calderon Kidd Comfort Dental Of S.E. Denver CarePOS 3488 S Willow St Denver General Dentist Dr. John A Short Dental Health At 16th Street Mall, Pllc (General Dentists) CarePOS 1600 Stout St Ste Denver General Dentist Dr. John A Short Dental Health Of Dtc CarePOS 5031 S Ulster St Ste Denver General Dentist Dr. John A Short Dental Health At Midtown Pllc CarePOS 2005 Franklin St Bldg 2 Ste Denver General Dentist Dr. John Adams Comfort Dental - North Denver ADP # W 38th Ave # Denver General Dentist *, **, C, E1-2, E3-4 Page 8 of 21

17 Dr. John D Hanchett Comfort Dental - South Denver CarePOS 3488 S Willow St Denver General Dentist Dr. Julie Mankin Kid'S Dental CarePOS 7901 E Colfax Ave Denver General Dentist Dr. Julie Mankin Kid'S Dental CarePOS 495 S Federal Blvd Denver General Dentist Dr. Katie S Steele Steele Dentistry Of Stapleton CarePOS 3545 Quebec St Ste Denver General Dentist Dr. Kelly White Auraria Dental Centre ADP # W Colfax, Ste G Denver General Dentist **, E1-2, E3-4 Dr. Kenneth Chernoff Dr. Timothy Wachuta ADP # S Colorado Blvd Denver General Dentist C, E1-2, E3-4 Dr. Kye W Lee Kye W Lee CarePOS 7159 E Hampden Ave Denver General Dentist Dr. Lauren Peterson Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. Lauren Peterson Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Lawrence D Yahnian Dental Health At 16th Street Mall, Pllc (General Dentists) CarePOS 1600 Stout St Ste Denver General Dentist Dr. Lawrence D Yahnian Dental Health Of Dtc CarePOS 5031 S Ulster St Ste Denver General Dentist Dr. Lawrence D Yahnian Dental Health At Midtown Pllc CarePOS 2005 Franklin St Bldg 2 Ste Denver General Dentist Dr. Lindsey Schroepfer Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. Lindsey Schroepfer Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Lonnie L Mcmurtrey Willow Run Dental CarePOS Zuni St Ste Denver General Dentist Dr. Lyda Martinez Comfort Dental - North Denver ADP # W 38th Ave # Denver General Dentist *, **, C, E1-2, E3-4 Dr. Manisha Patil Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. Manisha Patil Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Mariano De La Riva Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. Mario A Martinez Comfort Dental Of S.E. Denver CarePOS 3488 S Willow St Denver General Dentist Dr. Mark Jolsted Comfort Dental - Cherry Creek ADP # University Blvd, # Denver General Dentist *, C, E1-2, E3-4 Dr. Metodi A Milushev Dental Health At 16th Street Mall, Pllc (General Dentists) CarePOS 1600 Stout St Ste Denver General Dentist Dr. Metodi A Milushev Dental Health Of Dtc CarePOS 5031 S Ulster St Ste Denver General Dentist Dr. Metodi A Milushev Dental Health At Midtown Pllc CarePOS 2005 Franklin St Bldg 2 Ste Denver General Dentist Dr. Michael Raizen Dental Access Center CarePOS 3216 High St Denver General Dentist Dr. Noah Ariola-Tirella Ata Dental Center ADP # Lincoln St # Denver General Dentist *, C, E1-2, E3-4 Dr. Norris Sadler Dentistry For The Family CarePOS 3025 W 38th Ave Denver General Dentist Dr. Phillip S Johnson Hampden Family Dentistry & Orthodontics CarePOS 9250 E Hampden Ave Denver General Dentist Dr. Richard H Koch Greentree Dental ADP # E Hampden Ave # Denver General Dentist *, **, C, E1-2, E3-4 Dr. Robert Unrath Comfort Dental - North Denver ADP # W 38th Ave # Denver General Dentist *, **, C, E1-2, E3-4 Dr. Saul Escala Escala Family Dentistry ADP # S Federal Blvd Denver General Dentist *, **, C, E1-2, E3-4 Dr. Semiramida Condoianis Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. Semiramida Condoianis Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Sergio M Lopez Sergio M. Lopez D.D.S. ADP # Cherry Creek N Dr # Denver General Dentist *, **, C, E1-2, E3-4 Dr. Stephen M Perry Dental Health At 16th Street Mall, Pllc (General Dentists) CarePOS 1600 Stout St Ste Denver General Dentist Dr. Stephen M Perry Dental Health Of Dtc CarePOS 5031 S Ulster St Ste Denver General Dentist Dr. Stuart D Penk Stuart D Penk CarePOS 2005 Franklin St Ste Denver General Dentist Dr. Thomas J Kilroy Thomas J Kilroy CarePOS 5400 W Jewell Ave Ste 2b Denver General Dentist Dr. Thomas Mulheran Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. Thomas Mulheran Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Thomas Pyne Dr. Thomas Pyne ADP # E 45th Ave, # Denver General Dentist *, C, E1-2, E3-4 Dr. Thomas Sniegowski Dr. Thomas Sniegowski ADP # Dakin St, Ste # Denver General Dentist *, E3-4, N Dr. Tiffany Fritz Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Timothy Wachuta Dr. Timothy Wachuta ADP # S Colorado Blvd Denver General Dentist C, E1-2, E3-4 Page 9 of 21

18 Dr. Todd C Rinaldi Todd Rinaldi CarePOS 8751 E Hampden Ave Ste A Denver General Dentist Dr. Todd Light Comfort Dental - Cherry Creek ADP # University Blvd, # Denver General Dentist *, C, E1-2, E3-4 Dr. Vidhyalakshmi Sampath Bright Now Dental - Denver Downtown ADP # Arapahoe St, Ste A Denver General Dentist C, E1-2, E3-4 Dr. Vidhyalakshmi Sampath Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr North, # Denver General Dentist C, N Dr. Yinghui J Sun Dental Health Of Dtc CarePOS 5031 S Ulster St Ste Denver General Dentist Dr. Kenneth C Maughan Community Health Clinic CarePOS 495 W 4th St Dove Creek General Dentist Dr. Amanda T Jozsa Edgewater Modern Dentistry And Orthodontics CarePOS 1921 Sheridan Blvd Ste F Edgewater General Dentist Dr. Darren A Bennett Sloanside Dental CarePOS 2045 Sheridan Blvd Ste H Edgewater General Dentist Dr. David Rebber Comfort Dental - Englewood ADP # S Broadway Englewood General Dentist *, C, E1-2, E3-4, N Dr. Hillery J Oliver Comfort Dental - Englewood ADP # S Broadway Englewood General Dentist *, C, E1-2, E3-4, N Dr. James M Brown Comfort Dental - Englewood ADP # S Broadway Englewood General Dentist *, C, E1-2, E3-4, N Dr. Jason Ray Dentistry At Lincoln Center ADP # E Lincoln Ave # Englewood General Dentist **, C, E1-2, E3-4 Dr. Larry Nessel Comfort Dental - Englewood ADP # S Broadway Englewood General Dentist *, C, E1-2, E3-4, N Dr. Neil Cowen Dr. Neil Cowen ADP # S Lafayette, Suite Englewood General Dentist *, C, E1-2 Dr. Paul S Weyman Paul S Weyman CarePOS 3601 S Clarkson St Ste Englewood General Dentist Dr. Ricardo B Desilva Dasilva Family Dentistry CarePOS E Briarwood Ave Ste Englewood General Dentist Dr. Ryan M Redfearn Legacy Dental Group P.C. CarePOS 3601 S Clarkson St Ste Englewood General Dentist Dr. Walter E Schneider Avalon Dental CarePOS 5039 S Federal Blvd Ste Englewood General Dentist Dr. Kelly B Wettstein Impressions Dental CarePOS 615 Mitchell Way Ste Erie General Dentist Dr. Cory S Higginbotham Comfort Dental-Westminster ADP # N Federal Blvd Federal Heights General Dentist *, **, C, E1-2, E3-4 Dr. David Yeats Comfort Dental-Westminster ADP # N Federal Blvd Federal Heights General Dentist *, **, C, E1-2, E3-4 Dr. Helen Stella Comfort Dental-Westminster ADP # N Federal Blvd Federal Heights General Dentist *, **, C, E1-2, E3-4 Dr. Hiba Kellow Comfort Dental-Westminster ADP # N Federal Blvd Federal Heights General Dentist *, **, C, E1-2, E3-4 Dr. Dawne E Adams Longs Peak Dentistry CarePOS 8196 Colorado Blvd Ste Firestone General Dentist Dr. Abraham M Miller Fort Collins Dental Group CarePOS 2310 E Harmony Rd Ste Fort Collins General Dentist Dr. Alois Tripam Comfort Dental - Ft. Collins ADP # S Lemay Fort Collins General Dentist C, E1-2, N Dr. Bradley W Eckhardt Front Range Dental Center Pllc CarePOS 2720 Council Tree Ave Ste Fort Collins General Dentist Dr. Charles F Rodgers Fort Collins Dental Group CarePOS 2310 E Harmony Rd Ste Fort Collins General Dentist Dr. Charles F Rodgers Fort Collins Modern Dentistry CarePOS 2203 S College Ave Ste Fort Collins General Dentist Dr. Ciaran Finbar Murphy Harbor Dental Clinic ADP # S Timberline Rd# Fort Collins General Dentist C, E1-2, E3-4 Dr. Craig A Mellor Bright Now Dental - Fort Collins ADP # E Elizabeth St, # Fort Collins General Dentist C, E1-2 Dr. Douglas Haschke Comfort Dental - Ft. Collins ADP # S Lemay Fort Collins General Dentist C, E1-2, N Dr. Geoffery Dilbert Bright Now Dental - Fort Collins ADP # E Elizabeth St, # Fort Collins General Dentist C, E1-2 Dr. Jack F Emmons Bright Now Dental - Fort Collins ADP # E Elizabeth St, # Fort Collins General Dentist C, E1-2 Dr. James A Fischer James A Fischer CarePOS 1331 E Prospect Rd Unit B Fort Collins General Dentist Dr. James A Fischer Bright Now Dental - Fort Collins ADP # E Elizabeth St, # Fort Collins General Dentist C, E1-2 Dr. Jamie Fillmore Comfort Dental - Ft. Collins ADP # S Lemay Fort Collins General Dentist C, E1-2, N Dr. Jon F Matthes Fort Collins Modern Dentistry CarePOS 2203 S College Ave Ste Fort Collins General Dentist Dr. Katerina Sorensen Comfort Dental - Ft. Collins ADP # S Lemay Fort Collins General Dentist C, E1-2, N Dr. Leslie Johnson Rocky Mountain Dental Care CarePOS 1027 Robertson St Fort Collins General Dentist Dr. Mariano De La Riva Bright Now Dental - Fort Collins ADP # E Elizabeth St, # Fort Collins General Dentist C, E1-2 Dr. Nathan Eames Comfort Dental- South College ADP # S College Ave #a Fort Collins General Dentist *, **, C, E1-2, E3-4 Dr. Scott Bares Bright Now Dental - Fort Collins ADP # E Elizabeth St, # Fort Collins General Dentist C, E1-2 Dr. Thomas Mulheran Bright Now Dental - Fort Collins ADP # E Elizabeth St, # Fort Collins General Dentist C, E1-2 Page 10 of 21

19 Dr. Candace K Pfister Mesa Ridge Dental Center CarePOS 6980 Mesa Ridge Pkwy Fountain General Dentist Dr. Jeffrey A Ranta Mesa Ridge Dental Center CarePOS 6980 Mesa Ridge Pkwy Fountain General Dentist Dr. Ryan Reposa Mesa Ridge Dental Center CarePOS 6980 Mesa Ridge Pkwy Fountain General Dentist Dr. Thomas L Losacco Dr. Thomas L. Losacco ADP # th St Georgetown General Dentist *, C, E1-2, E3-4, N Dr. Ashleigh S Harrison Cherry Creek Modern Dentistry CarePOS 1100 S Colorado Blvd Glendale General Dentist Dr. Charles F Rodgers Cherry Creek Modern Dentistry CarePOS 1100 S Colorado Blvd Glendale General Dentist Dr. Jenna A Nicholson Cherry Creek Modern Dentistry CarePOS 1100 S Colorado Blvd Glendale General Dentist Dr. Benjamin D Coon Glenwood Meadows Dental ADP # A Market Street Glenwood Springs General Dentist **, C, E1-2, E3-4 Dr. Brian Talley Comfort Dental - Glenwood Springs ADP # Grand Ave Glenwood Springs General Dentist *, **, C, E1-2, E3-4 Dr. Michael Shea Comfort Dental - Glenwood Springs ADP # Grand Ave Glenwood Springs General Dentist *, **, C, E1-2, E3-4 Dr. Heath Colledge Comfort Dental - Golden ADP # S Golden Rd Golden General Dentist *, **, C, E1-2, E3-4 Dr. Jason Noah Comfort Dental - Golden ADP # S Golden Rd Golden General Dentist *, **, C, E1-2, E3-4 Dr. Kenneth Chernoff Dr. Timothy Wachuta ADP # Jackson St Golden General Dentist C, E1-2, E3-4 Dr. Nicholas L Groneman Comfort Dental - Golden ADP # S Golden Rd Golden General Dentist *, **, C, E1-2, E3-4 Dr. Paulette Dilizia Comfort Dental - Golden ADP # S Golden Rd Golden General Dentist *, **, C, E1-2, E3-4 Dr. Scott Welch Golden View Dental ADP # Simms St, #e Golden General Dentist *, **, C, E1-2, E3-4 Dr. Timothy Wachuta Dr. Timothy Wachuta ADP # Jackson St Golden General Dentist C, E1-2, E3-4 Dr. James Bradley Comfort Dental-Grand Junction ADP # North Ave Grand Junction General Dentist *, **, C, E1-2, E3-4 Dr. James M Tarr Dr. James M. Tarr ADP # W Pinyon Ave Grand Junction General Dentist C, E1-2 Dr. Karl M Kunstadter Skyline Dental Clinic CarePOS 2795 Skyline Ct Grand Junction General Dentist Dr. Matthew Hudson Hudson Family Dental ADP # Walnut Ave # Grand Junction General Dentist *, C, E1-2, E3-4 Dr. Michael Shea Comfort Dental-Grand Junction ADP # North Ave Grand Junction General Dentist *, **, C, E1-2, E3-4 Dr. Scotty N Van Dusen Skyline Dental Clinic CarePOS 2795 Skyline Ct Grand Junction General Dentist Dr. Thomas Sorensen Comfort Dental-Grand Junction ADP # North Ave Grand Junction General Dentist *, **, C, E1-2, E3-4 Dr. Alex Knecht Sunrise Dental Center ADP # A St Greeley General Dentist *, **, C, E1-2, E3-4 Dr. Allan G Skromme Dental Health Of Greeley CarePOS rd Ave Ste Greeley General Dentist Dr. Amir A Hashemi Dental Health Of Greeley CarePOS rd Ave Ste Greeley General Dentist Dr. Andrey A Kondratenko Comfort Dental - Greeley ADP # West 10th St Greeley General Dentist **, C, E1-2, E3-4 Dr. Bahar Esmaili Dental Health Of Greeley CarePOS rd Ave Ste Greeley General Dentist Dr. Brian Elliott Dental Health Of Greeley CarePOS rd Ave Ste Greeley General Dentist Dr. Charles F Rodgers Greeley Modern Dentistry CarePOS th St Ste Greeley General Dentist Dr. Charles W Johnson Dental Health Of Greeley CarePOS rd Ave Ste Greeley General Dentist Dr. Courtney Stevens Comfort Dental - Greeley ADP # West 10th St Greeley General Dentist **, C, E1-2, E3-4 Dr. Dinorah Moya Sunrise Dental Center ADP # A St Greeley General Dentist *, **, C, E1-2, E3-4 Dr. Donald Langley Dental Health Of Greeley CarePOS rd Ave Ste Greeley General Dentist Dr. Dwayne A Moore Dental Health Of Greeley CarePOS rd Ave Ste Greeley General Dentist Dr. John A Short Dental Health Of Greeley CarePOS rd Ave Ste Greeley General Dentist Dr. Kent Day Sunrise Dental Center ADP # A St Greeley General Dentist *, **, C, E1-2, E3-4 Dr. Lawrence D Yahnian Dental Health Of Greeley CarePOS rd Ave Ste Greeley General Dentist Dr. Mario Montanez Adventure Dental CarePOS 3485 W 10th St Ste C Greeley General Dentist Dr. Metodi A Milushev Dental Health Of Greeley CarePOS rd Ave Ste Greeley General Dentist Dr. Patrick Harrison Sunrise Dental Center ADP # A St Greeley General Dentist *, **, C, E1-2, E3-4 Dr. Patrick Rinaldis Comfort Dental - Greeley ADP # West 10th St Greeley General Dentist **, C, E1-2, E3-4 Dr. Randy C Hatch Dental Health Of Greeley CarePOS rd Ave Ste Greeley General Dentist Page 11 of 21

20 Dr. Ronald B Montano Adventure Dental CarePOS 3485 W 10th St Ste C Greeley General Dentist Dr. Shivaun Mcartor Sunrise Dental Center ADP # A St Greeley General Dentist *, **, C, E1-2, E3-4 Dr. Stephen Brown Dr. Stephen Brown ADP # W 16th St, Bldg 3, Ste S Greeley General Dentist **, E1-2 Dr. Stephen M Perry Dental Health Of Greeley CarePOS rd Ave Ste Greeley General Dentist Dr. Elena I Bodoni Elena Isabela Bodoni DDS CarePOS 8000 E Prentice Ave Ste B Greenwood Village General Dentist Dr. Lawrence M Kuljis Lawrence M Kuljis CarePOS 8200 E Belleview Ave Ste Greenwood Village General Dentist Dr. Aaron K Kubicek Falcon Park Dental Group CarePOS 9579 S University Blvd Unit 400a Highlands Ranch General Dentist Dr. Berween Mourady Redstone Dental Group/ny Kids Dentist And Orthodontics CarePOS 1165 Sgt Jon Stiles Dr Highlands Ranch General Dentist Dr. Bradford J O'Neill Falcon Park Dental Group CarePOS 9579 S University Blvd Unit 400a Highlands Ranch General Dentist Dr. Brian A Ozenbaugh Redstone Dental Group/ny Kids Dentist And Orthodontics CarePOS 1165 Sgt Jon Stiles Dr Highlands Ranch General Dentist Dr. Brian Kajewski Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. Charles F Rodgers Falcon Park Dental Group CarePOS 9579 S University Blvd Unit 400a Highlands Ranch General Dentist Dr. Charles Woyda Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. Christopher Bentley Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. Cory M Johnston Redstone Dental Group/ny Kids Dentist And Orthodontics CarePOS 1165 Sgt Jon Stiles Dr Highlands Ranch General Dentist Dr. Craig A Mellor Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. Ekatrina Butkevich Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. Henry D Ahn Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. James A Fischer Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. Katie S Bratlien-Kirby Redstone Dental Group/ny Kids Dentist And Orthodontics CarePOS 1165 Sgt Jon Stiles Dr Highlands Ranch General Dentist Dr. Kenneth M Burson Falcon Park Dental Group CarePOS 9579 S University Blvd Unit 400a Highlands Ranch General Dentist Dr. Malgorzata R Korosciel Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. Manisha Patil Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. Matthew Stevens Comfort Dental - Highlands Ranch ADP # W County Line Rd Highlands Ranch General Dentist *, **, C, E1-2, E3-4 Dr. Michael Love Comfort Dental - Highlands Ranch ADP # W County Line Rd Highlands Ranch General Dentist *, **, C, E1-2, E3-4 Dr. Michael Miller Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. Nina Gomenyuk Comfort Dental - Highlands Ranch ADP # W County Line Rd Highlands Ranch General Dentist *, **, C, E1-2, E3-4 Dr. Semiramida Condoianis Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. Susan Kutis Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. Thomas Mulheran Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. Tiffany Fritz Bright Now Dental - Highlands Ranch ADP # Highlands Rnch Pkwy # Highlands Ranch General Dentist *, **, E1-2, E3-4, N Dr. David Dinsmore 95th Street Dental ADP # Forest Park Circle # Lafayette General Dentist *, **, C, E1-2, E3-4 Dr. Evan Kneale Comfort Dental - Lafayette ADP # W South Boulder Rd, # Lafayette General Dentist *, **, C, E1-2, E3-4 Dr. Jarom Paice Comfort Dental - Lafayette ADP # W South Boulder Rd, # Lafayette General Dentist *, **, C, E1-2, E3-4 Dr. Marc Yasoni Comfort Dental - Lafayette ADP # W South Boulder Rd, # Lafayette General Dentist *, **, C, E1-2, E3-4 Dr. Andreea Torok Comfort Dental- Green Mountain ADP # W Alameda Ave Lakewood General Dentist *, **, C, E1-2, E3-4 Dr. Aneeta Pucheril Pinnacle Dental CarePOS 2500 Youngfield St Ste Lakewood General Dentist Dr. Bahar Esmaili Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Brian Kajewski Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Bruce H Johnson Bruce H. Johnson ADP # W Girton Dr Lakewood General Dentist *, **, C, E1-2 Dr. Charles F Rodgers Crestline Dental Group And Orthodontics CarePOS 5392 S Wadsworth Blvd Unit Lakewood General Dentist Dr. Charles Woyda Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Christopher Bentley Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Craig A Mellor Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Page 12 of 21

21 Dr. Efren Martinez Dr. Efren Martinez ADP # S Wadsworth Lakewood General Dentist **, E1-2, E3-4 Dr. Ekatrina Butkevich Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Eloisa Lovato Comfort Dental- Bear Creek ADP # S Wadsworth Blvd #e Lakewood General Dentist *, **, C, E1-2, E3-4 Dr. Eric J Palacios Crestline Dental Group And Orthodontics CarePOS 5392 S Wadsworth Blvd Unit Lakewood General Dentist Dr. Frank Gold Frank J Gold DDS PC CarePOS 1360 Wadsworth Blvd Ste Lakewood General Dentist Dr. Henry D Ahn Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Jace Williamson Comfort Dental- Green Mountain ADP # W Alameda Ave Lakewood General Dentist *, **, C, E1-2, E3-4 Dr. Jackson Nguyen Comfort Dental- Green Mountain ADP # W Alameda Ave Lakewood General Dentist *, **, C, E1-2, E3-4 Dr. James A Fischer Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Jeffrey Bernardy Comfort Dental- Bear Creek ADP # S Wadsworth Blvd #e Lakewood General Dentist *, **, C, E1-2, E3-4 Dr. Jennifer K Lee Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Joesolyn Caldron-Kidd Comfort Dental- Bear Creek ADP # S Wadsworth Blvd #e Lakewood General Dentist *, **, C, E1-2, E3-4 Dr. Kathryn S Buss Crestline Dental Group And Orthodontics CarePOS 5392 S Wadsworth Blvd Unit Lakewood General Dentist Dr. Lauren Peterson Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Lindsey Schroepfer Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Malgorzata R Korosciel Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Manisha Patil Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Michael Miller Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Olen C Crockett Olen C. Crockett CarePOS 1345 Wadsworth Blvd Lakewood General Dentist Dr. Richard Glucksman Alpha Dental Xx ADP # W Jefferson, # Lakewood General Dentist *, N Dr. Snahel Prajapati Comfort Dental- Bear Creek ADP # S Wadsworth Blvd #e Lakewood General Dentist *, **, C, E1-2, E3-4 Dr. Stephanie Paswaters Emerald Dental CarePOS W Alameda Pkwy Ste A Lakewood General Dentist Dr. Susan Kutis Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Thomas Mulheran Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Vidhyalakshmi Sampath Bright Now Dental - Lakewood ADP # W Colfax Ave, #d Lakewood General Dentist *, C, E1-2 Dr. Vidhyalakshmi Sampath Crestline Dental Group And Orthodontics CarePOS 5392 S Wadsworth Blvd Unit Lakewood General Dentist Dr. William J Hartman Crestline Dental Group And Orthodontics CarePOS 5392 S Wadsworth Blvd Unit Lakewood General Dentist Dr. William J Mcglashan Crestline Dental Group And Orthodontics CarePOS 5392 S Wadsworth Blvd Unit Lakewood General Dentist Dr. Ibraheem Ackall Highplains Community Health Center ADP # Kendall Drive Lamar General Dentist **, C, E1-2 Dr. Brittany Bevis Pineland Dental CarePOS 8520 Spruce Mountain Rd Ste Larkspur General Dentist Dr. Bill Bender Dr. Bill Bender ADP # nd St Lasalle General Dentist *, **, C, E1-2 Dr. Jennina A Townsend Plains Medical Center CarePOS 820 1st St Limon General Dentist Dr. Kevin Z Dawson Plains Medical Center CarePOS 820 1st St Limon General Dentist Dr. Bill Oldershaw Comfort Dental - Littleton ADP # W Coal Mine Ave Littleton General Dentist *, C, E1-2, E3-4 Dr. Brad Weekes Comfort Dental - Littleton ADP # W Coal Mine Ave Littleton General Dentist *, C, E1-2, E3-4 Dr. Brandon S Burgar Prestige Dental Care CarePOS 8340 Sangre De Cristo Rd Ste Littleton General Dentist Dr. Brian L Richardson Banchard & Richardson Family Dentistry CarePOS 8089 S Lincoln St Ste Littleton General Dentist Dr. Cindy Kempton-St Onge Cindy Kempton DDS CarePOS 7261 S Broadway Ste Littleton General Dentist Dr. David D Daugherty Aspen View Dental CarePOS 5104 S Field St Ste A Littleton General Dentist Dr. David Kim Comfort Dental - Littleton ADP # W Coal Mine Ave Littleton General Dentist *, C, E1-2, E3-4 Dr. Ellias Najjar Belleview Dental Associates ADP # W Belleview Littleton General Dentist * Dr. Heather A Sturdivant Southpark Orthodontics CarePOS 8199 Southpark Ln Ste Littleton General Dentist Dr. James M Preston James M Preston, DDS CarePOS 5950 S Platte Canyon Rd Ste D Littleton General Dentist Dr. Jason L Blanchard Blanchard & Richardson Family Dentistry CarePOS 8089 S Lincoln St Ste Littleton General Dentist Page 13 of 21

22 Dr. Jeffrey Spiegel Comfort Dental- Littleton Blvd. ADP # B W Littleton Blvd Littleton General Dentist *, **, C, E1-2, E3-4, N Dr. Katrina Rojohn Comfort Dental- Belleview & Simms ADP # W Belleview Littleton General Dentist *, **, C, E1-2, E3-4 Dr. Margareta Pavel Dutch Creek Dental ADP # W Coal Mine Ave, # Littleton General Dentist *, C, E1-2, E3-4 Dr. Richard J Birkel Comfort Dental- Littleton Blvd. ADP # B W Littleton Blvd Littleton General Dentist *, **, C, E1-2, E3-4, N Dr. Scot S Thompson Brighter Dental CarePOS 7735 W Long Dr Unit Littleton General Dentist Dr. Semiramida Condoianis Comfort Dental- Belleview & Simms ADP # W Belleview Littleton General Dentist *, **, C, E1-2, E3-4 Dr. Tam Than Comfort Dental- Belleview & Simms ADP # W Belleview Littleton General Dentist *, **, C, E1-2, E3-4 Dr. Thomas Klumb Comfort Dental - Littleton ADP # W Coal Mine Ave Littleton General Dentist *, C, E1-2, E3-4 Dr. Todd S Oldroyd Oldroyd Family Dentistry CarePOS 8340 Sangre De Cristo Rd Ste Littleton General Dentist Dr. Caitlin E White Lone Tree Dentists CarePOS Commons St Lone Tree General Dentist Dr. Charles F Rodgers Lone Tree Dentists CarePOS Commons St Lone Tree General Dentist Dr. Cory J Fabrizio Lone Tree Dentists CarePOS Commons St Lone Tree General Dentist Dr. Daniel Larscheid Dentistry At The Crest ADP # Park Meadows Dr #-B Lone Tree General Dentist *, **, C, E1-2, E3-4 Dr. Joseph Dastrup Lone Tree Dentists CarePOS Commons St Lone Tree General Dentist Dr. Richard Handelman Dentistry At The Crest ADP # Park Meadows Dr #-B Lone Tree General Dentist *, **, C, E1-2, E3-4 Dr. Aaron D Mortensen Comfort Dental - Longmont ADP # Mountain View Longmont General Dentist *, **, C, E1-2, E3-4 Dr. Allan G Skromme Dental Health Of Longmont CarePOS 1260 S Hover St Ste H Longmont General Dentist Dr. Amir A Hashemi Dental Health Of Longmont CarePOS 1260 S Hover St Ste H Longmont General Dentist Dr. Bahar Esmaili Dental Health Of Longmont CarePOS 1260 S Hover St Ste H Longmont General Dentist Dr. Bahar Esmaili Bright Now Dental - Longmont ADP #59 15 Ken Pratt Blvd, # Longmont General Dentist *, C, E1-2, E3-4 Dr. Brian Elliott Dental Health Of Longmont CarePOS 1260 S Hover St Ste H Longmont General Dentist Dr. Conrad Stutznegger Comfort Dental - Longmont ADP # Mountain View Longmont General Dentist *, **, C, E1-2, E3-4 Dr. Craig A Mellor Bright Now Dental - Longmont ADP #59 15 Ken Pratt Blvd, # Longmont General Dentist *, C, E1-2, E3-4 Dr. Dale Roberts Dental Health Of Longmont CarePOS 1260 S Hover St Ste H Longmont General Dentist Dr. David R Maki Bright Now Dental - Longmont ADP #59 15 Ken Pratt Blvd, # Longmont General Dentist *, C, E1-2, E3-4 Dr. Dianne R Pierson Longmont Family Dental LLC CarePOS 1503 Mountain View Ave Longmont General Dentist Dr. Donald Langley Dental Health Of Longmont CarePOS 1260 S Hover St Ste H Longmont General Dentist Dr. Dwayne A Moore Dental Health Of Longmont CarePOS 1260 S Hover St Ste H Longmont General Dentist Dr. Geoffery Dilbert Bright Now Dental - Longmont ADP #59 15 Ken Pratt Blvd, # Longmont General Dentist *, C, E1-2, E3-4 Dr. Jack F Emmons Bright Now Dental - Longmont ADP #59 15 Ken Pratt Blvd, # Longmont General Dentist *, C, E1-2, E3-4 Dr. James A Fischer Bright Now Dental - Longmont ADP #59 15 Ken Pratt Blvd, # Longmont General Dentist *, C, E1-2, E3-4 Dr. John A Short Dental Health Of Longmont CarePOS 1260 S Hover St Ste H Longmont General Dentist Dr. Jolly Johnson Comfort Dental - Longmont ADP # Mountain View Longmont General Dentist *, **, C, E1-2, E3-4 Dr. Lauren Peterson Bright Now Dental - Longmont ADP #59 15 Ken Pratt Blvd, # Longmont General Dentist *, C, E1-2, E3-4 Dr. Lawrence D Yahnian Dental Health Of Longmont CarePOS 1260 S Hover St Ste H Longmont General Dentist Dr. Mariano De La Riva Bright Now Dental - Longmont ADP #59 15 Ken Pratt Blvd, # Longmont General Dentist *, C, E1-2, E3-4 Dr. Metodi A Milushev Dental Health Of Longmont CarePOS 1260 S Hover St Ste H Longmont General Dentist Dr. Mona Omran Bright Now Dental - Longmont ADP #59 15 Ken Pratt Blvd, # Longmont General Dentist *, C, E1-2, E3-4 Dr. Stephen Brown Affordable Dental Clinic ADP # Terry St Longmont General Dentist *, E1-2 Dr. Stephen M Perry Dental Health Of Longmont CarePOS 1260 S Hover St Ste H Longmont General Dentist Dr. Stephen Sidwell Comfort Dental - Longmont ADP # Mountain View Longmont General Dentist *, **, C, E1-2, E3-4 Dr. Thomas Mulheran Bright Now Dental - Longmont ADP #59 15 Ken Pratt Blvd, # Longmont General Dentist *, C, E1-2, E3-4 Dr. Abraham Miller Comfort Dental - Louisville ADP # Mccaslin Blvd, #b Louisville General Dentist *, **, C, E1-2, E3-4 Dr. Doug Duey Comfort Dental - Louisville ADP # Mccaslin Blvd, #b Louisville General Dentist *, **, C, E1-2, E3-4 Page 14 of 21

23 Dr. Stephen Spencer Comfort Dental - Louisville ADP # Mccaslin Blvd, #b Louisville General Dentist *, **, C, E1-2, E3-4 Dr. Charles F Rodgers Loveland Modern Dentistry CarePOS 255 W 64th St Loveland General Dentist Dr. Charles F Rodgers Loveland Dental Group CarePOS 1569 Fall River Dr Ste Loveland General Dentist Dr. Craig A Mellor Bright Now Dental - Loveland ADP # W 29th St, # Loveland General Dentist **, E1-2 Dr. Daniel B Howard Loveland Dental Group CarePOS 1569 Fall River Dr Ste Loveland General Dentist Dr. Ekatrina Butkevich Bright Now Dental - Loveland ADP # W 29th St, # Loveland General Dentist **, E1-2 Dr. Geoffery Dilbert Bright Now Dental - Loveland ADP # W 29th St, # Loveland General Dentist **, E1-2 Dr. Gregory S Winslow Comfort Dental- North Loveland ADP # W 64th St Loveland General Dentist **, C, E1-2, E3-4, N Dr. Jack F Emmons Bright Now Dental - Loveland ADP # W 29th St, # Loveland General Dentist **, E1-2 Dr. James A Fischer Bright Now Dental - Loveland ADP # W 29th St, # Loveland General Dentist **, E1-2 Dr. Jeffery Bourne Comfort Dental- North Loveland ADP # W 64th St Loveland General Dentist **, C, E1-2, E3-4, N Dr. Katherine Harmon Kindergrins Dental CarePOS 126 E 29th St Loveland General Dentist Dr. Mariano De La Riva Bright Now Dental - Loveland ADP # W 29th St, # Loveland General Dentist **, E1-2 Dr. Mikal Lindman Comfort Dental- North Loveland ADP # W 64th St Loveland General Dentist **, C, E1-2, E3-4, N Dr. Pamela B Lerfald Loveland Modern Dentistry CarePOS 255 W 64th St Loveland General Dentist Dr. Patrick Harrison Loveland Community Health Center ADP # N Cleveland Ave Loveland General Dentist *, **, C, E1-2, E3-4 Dr. Susan Kutis Bright Now Dental - Loveland ADP # W 29th St, # Loveland General Dentist **, E1-2 Dr. Thomas Mulheran Bright Now Dental - Loveland ADP # W 29th St, # Loveland General Dentist **, E1-2 Dr. Richard A Shulze The Lions Tooth LLC CarePOS 304 Main St Lyons General Dentist Dr. Chris B Poe Black Canyon Dental CarePOS 1544 Oxbow Dr Ste Montrose General Dentist Dr. Daniel P Reardon Black Canyon Dental CarePOS 1544 Oxbow Dr Ste Montrose General Dentist Dr. Christopher Hasselback Comfort Dental-Monument ADP # W Highway Monument General Dentist *, C, E1-2, E3-4 Dr. Michael Gioia Comfort Dental-Monument ADP # W Highway Monument General Dentist *, C, E1-2, E3-4 Dr. Michael S Peppler Palmer Ridge Orthodontics CarePOS 1777 Lake Woodmoor Dr Monument General Dentist Dr. Steve Carter Comfort Dental-Monument ADP # W Highway Monument General Dentist *, C, E1-2, E3-4 Dr. Victoria L Driskill Comfort Dental-Monument ADP # W Highway Monument General Dentist *, C, E1-2, E3-4 Dr. Aurora Saddler Comfort Dental CarePOS Washington St Northglenn General Dentist Dr. Bruce W Irick Comfort Dental Northglenn CarePOS Washington St Northglenn General Dentist Dr. Cory G Best Comfort Dental Groupt Of Northglen CarePOS Washington St Northglenn General Dentist Dr. Robert D Jefferies Comfort Dental CarePOS Washington St Northglenn General Dentist Dr. Roy A Martin Comfort Dental Northglenn CarePOS Washington St Northglenn General Dentist Dr. Stewart Moss Stuart Moss & Associates ADP #4 421 W 104th Ave, # Northglenn General Dentist *, **, C, E1-2 Dr. Brian P Babin Mountain Dental Parker CarePOS S Twenty Mile Rd Ste Parker General Dentist Dr. Christopher B Bentley All Care CarePOS S Twenty Mile Rd Ste Parker General Dentist Dr. Erin R Sundt Mountain Dental Parker CarePOS S Twenty Mile Rd Ste Parker General Dentist Dr. Luis J Bravo Mountain Dental Parker CarePOS S Twenty Mile Rd Ste Parker General Dentist Dr. Michael A Holm Comfort Dental - Parker ADP # Stroh Ranch Court Parker General Dentist *, C, E1-2, E3-4, N Dr. Michael G Hale Dr. Michael G. Hale ADP # E Mainstreet #r Parker General Dentist C, N Dr. Michael Miller Foxfield Dental ADP # E Arapahoe Rd # Parker General Dentist *, **, C, E1-2, E3-4 Dr. Ronald J Freimuth Comfort Dental - Parker ADP # Stroh Ranch Court Parker General Dentist *, C, E1-2, E3-4, N Dr. Scott Henderson Comfort Dental - Parker ADP # Stroh Ranch Court Parker General Dentist *, C, E1-2, E3-4, N Dr. Trevor G Johnson Comfort Dental - Parker ADP # Stroh Ranch Court Parker General Dentist *, C, E1-2, E3-4, N Dr. Chad J Murdock Comfort Dental-Falcon Hills ADP # Meridian Market View # Peyton General Dentist *, **, C, E1-2, E3-4 Dr. Joel Stafford Comfort Dental-Falcon Hills ADP # Meridian Market View # Peyton General Dentist *, **, C, E1-2, E3-4 Page 15 of 21

24 Dr. Jonathan Harvey Comfort Dental-Falcon Hills ADP # Meridian Market View # Peyton General Dentist *, **, C, E1-2, E3-4 Dr. Anthony Knowlton Dr. Anthony Knowlton ADP # Sandalwood Lane Pueblo General Dentist *, C, E1-2, E3-4 Dr. Bradley Michael Almond Comfort Dental - Pueblo - South ADP # S Pueblo Blvd Pueblo General Dentist *, **, C, E1-2, E3-4 Dr. Brady T Smith Comfort Dental - Pueblo - North ADP # W Us Hwy 50, Ste A Pueblo General Dentist *, **, C, E1-2, E3-4 Dr. Bridget J Doyle Derose Childrens Dental Clinic CarePOS 1022 Liberty Ln Pueblo General Dentist Dr. Charles G Gordon Charlie Gordon DDS Family Dentistry CarePOS 1026 Esglerige Blvd Pueblo General Dentist Dr. David B Robinson Belmont Dental Center CarePOS 1560 Bonforte Blvd Pueblo General Dentist Dr. Elden M Rice Comfort Dental - Pueblo - North ADP # W Us Hwy 50, Ste A Pueblo General Dentist *, **, C, E1-2, E3-4 Dr. Elmer A Villalon Elmer A Villalon CarePOS 1225 N Main St Ste Pueblo General Dentist Dr. Gary Graves Dr. Gary Graves ADP # S Pueblo Blvd Pueblo General Dentist *, **, C, E1-2 Dr. Gino Ortegon Dr. Gino Ortegon ADP # W12th St Pueblo General Dentist **, C, E1-2, N Dr. Jeffery A Moeller Comfort Dental - Pueblo - South ADP # S Pueblo Blvd Pueblo General Dentist *, **, C, E1-2, E3-4 Dr. John D Millea Park West Dental PC CarePOS 3470 Parker Blvd Pueblo General Dentist Dr. Juliann M Padula Park West Dental PC CarePOS 3470 Parker Blvd Pueblo General Dentist Dr. Karleen L Trefil Comfort Dental - Pueblo - North ADP # W Us Hwy 50, Ste A Pueblo General Dentist *, **, C, E1-2, E3-4 Dr. Kelli S Pershin Park West Dental PC CarePOS 3470 Parker Blvd Pueblo General Dentist Dr. Phillip Holden Comfort Dental - Pueblo - North ADP # W Us Hwy 50, Ste A Pueblo General Dentist *, **, C, E1-2, E3-4 Dr. Ralph Downey Comfort Dental - Pueblo - South ADP # S Pueblo Blvd Pueblo General Dentist *, **, C, E1-2, E3-4 Dr. Richard C Moreschini Dr. Richard C. Moreschini ADP # W 6th St Pueblo General Dentist C, E1-2, N Dr. Ronald J Ragulsky Ronald J. Ragulsky CarePOS 3939 Sandalwood Ln Pueblo General Dentist Dr. Steven P Rose Comfort Dental - Pueblo - South ADP # S Pueblo Blvd Pueblo General Dentist *, **, C, E1-2, E3-4 Dr. Thomas V Autobee Thomas V Autobee CarePOS 108 E Pitkin Ave Pueblo General Dentist Dr. Tony G Oreskovich Oreskovich Dental ADP # Pueblo Blvd Way, # Pueblo General Dentist E1-2, E3-4, N Dr. Tony L Roberts Tony Roberts CarePOS 1225 N Grand Ave Ste Pueblo General Dentist Dr. Vikash Kanchanlal Gentle Touch Family Dentistry ADP # Sandalwood Lane Pueblo General Dentist *, **, C, E1-2, E3-4 Dr. Bradford J O'Neill River Point Dental Group And Orthodontics CarePOS 3960 River Point Pkwy Unit A Sheridan General Dentist Dr. Charles F Rodgers River Point Dental Group And Orthodontics CarePOS 3960 River Point Pkwy Unit A Sheridan General Dentist Dr. Gail N Raether River Point Dental Group And Orthodontics CarePOS 3960 River Point Pkwy Unit A Sheridan General Dentist Dr. Jason D Conrad River Point Dental Group And Orthodontics CarePOS 3960 River Point Pkwy Unit A Sheridan General Dentist Dr. Joanne L Bancroft River Point Dental Group And Orthodontics CarePOS 3960 River Point Pkwy Unit A Sheridan General Dentist Dr. Katherine T Johnson River Point Dental Group And Orthodontics CarePOS 3960 River Point Pkwy Unit A Sheridan General Dentist Dr. Kenneth M Burson River Point Dental Group And Orthodontics CarePOS 3960 River Point Pkwy Unit A Sheridan General Dentist Dr. Wade R Hirschman River Point Dental Group And Orthodontics CarePOS 3960 River Point Pkwy Unit A Sheridan General Dentist Dr. John Rollow, Iv Comfort Dental- Summit County ADP # Blue River Pkwy #a Silverthorne General Dentist *, C, E1-2, E3-4 Dr. Lorraine Mundy Comfort Dental- Summit County ADP # Blue River Pkwy #a Silverthorne General Dentist *, C, E1-2, E3-4 Dr. Randall C Jones Randall C. Jones ADP # S 3rd Ave Sterling General Dentist *, C, E1-2, E3-4 Dr. Gregory B Kempers Plains Medical Center CarePOS E Colfax Ave Strasburg General Dentist Dr. Jennina A Townsend Plains Medical Center CarePOS E Colfax Ave Strasburg General Dentist Dr. Kevin Z Dawson Plains Medical Center CarePOS E Colfax Ave Strasburg General Dentist Dr. Sung K Kim Plains Medical Center CarePOS E Colfax Ave Strasburg General Dentist Dr. Bradford J O'Neill Marketplace Dental Group And Orthodontics CarePOS 306 Center Dr Superior General Dentist Dr. Carter C Christensen Marketplace Dental Group And Orthodontics CarePOS 306 Center Dr Superior General Dentist Dr. Charles F Rodgers Marketplace Dental Group And Orthodontics CarePOS 306 Center Dr Superior General Dentist Dr. Ethelyn G Thomason Marketplace Dental Group And Orthodontics CarePOS 306 Center Dr Superior General Dentist Page 16 of 21

25 Dr. Jack C Moss Marketplace Dental Group And Orthodontics CarePOS 306 Center Dr Superior General Dentist Dr. Jessica B Hetcko Marketplace Dental Group And Orthodontics CarePOS 306 Center Dr Superior General Dentist Dr. Katherine T Johnson Marketplace Dental Group And Orthodontics CarePOS 306 Center Dr Superior General Dentist Dr. Amir R Fereydouni Thornton Family Dentistry & Orthodontics CarePOS 2300 E 120th Ave Dte Thornton General Dentist Dr. Ana K Hasfura-Cadotte Comfort Dental- Thornton ADP # Huron St Thornton General Dentist *, **, C, E1-2, E3-4 Dr. April Sousa Comfort Dental Hunters Glen CarePOS Colorado Blvd Ste Thornton General Dentist Dr. Charles P Mccary Thornton Family Dentistry & Orthodontics CarePOS 2300 E 120th Ave Dte Thornton General Dentist Dr. Gerald R Smith Comfort Dental- Thornton ADP # Huron St Thornton General Dentist *, **, C, E1-2, E3-4 Dr. Hanh H Phi Thornton Family Dentistry & Orthodontics CarePOS 2300 E 120th Ave Dte Thornton General Dentist Dr. Jarum M Boyer Comfort Dental Hunters Glen CarePOS Colorado Blvd Ste Thornton General Dentist Dr. Jazmin F Cuin-Parker Comfort Dental- Thornton ADP # Huron St Thornton General Dentist *, **, C, E1-2, E3-4 Dr. Matthew H Coons Comfort Dental Hunters Glen CarePOS Colorado Blvd Ste Thornton General Dentist Dr. Susan C Bromell Comfort Dental- Thornton ADP # Huron St Thornton General Dentist *, **, C, E1-2, E3-4 Dr. Amy M Jorgensen Amazing Smiles CarePOS 7236 Federal Blvd Unit Westminster General Dentist Dr. Bahar Esmaili Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Dr. Bert L Moffitt Northview Dental Office CarePOS 5068 W 92nd Ave Westminster General Dentist Dr. Brian Kajewski Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Dr. Charles F Rodgers Walnut Creek Dental Group And Orthodontics CarePOS Town Center Dr Ste Westminster General Dentist Dr. Charles F Rodgers Orchard Dental Group And Orthodontics Llp CarePOS Orchard Pkwy Ste Westminster General Dentist Dr. Constanza Cubillos Comfort Dental-80th & Sheridan ADP # N Sheridan Blvd Westminster General Dentist *, **, C, E1-2, E3-4 Dr. Craig A Mellor Walnut Creek Dental Group And Orthodontics CarePOS Town Center Dr Ste Westminster General Dentist Dr. Craig A Mellor Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Dr. Ekatrina Butkevich Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Dr. Fredric Gohl Comfort Dental North Westminster CarePOS Sheridan Blvd Unit Westminster General Dentist Dr. Geoffery Dilbert Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Dr. Gerald R Smith Comfort Dental North Westminster CarePOS Sheridan Blvd Unit Westminster General Dentist Dr. Ian Ferguson Comfort Dental-80th & Sheridan ADP # N Sheridan Blvd Westminster General Dentist *, **, C, E1-2, E3-4 Dr. Jack F Emmons Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Dr. James A Fischer Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Dr. Jamie E Irwin Walnut Creek Dental Group And Orthodontics CarePOS Town Center Dr Ste Westminster General Dentist Dr. Jeremy B Rogers Comfort Dental North Westminster CarePOS Sheridan Blvd Unit Westminster General Dentist Dr. Jessica B Hetcko Walnut Creek Dental Group And Orthodontics CarePOS Town Center Dr Ste Westminster General Dentist Dr. Joseph K Spear Comfort Dental North Westminster CarePOS Sheridan Blvd Unit Westminster General Dentist Dr. Kenneth J Polke Dr Kenneth Polke DDS CarePOS 905 W 124th Ave Ste Westminster General Dentist Dr. Lauren Peterson Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Dr. Lindsey Schroepfer Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Dr. Luan K Tran Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Dr. Mariano De La Riva Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Dr. Matthew A Chapman Orchard Dental Group And Orthodontics Llp CarePOS Orchard Pkwy Ste Westminster General Dentist Dr. Ryan Mangrum Comfort Dental-80th & Sheridan ADP # N Sheridan Blvd Westminster General Dentist *, **, C, E1-2, E3-4 Dr. Scott M Tuchklaper Orchard Dental Group And Orthodontics Llp CarePOS Orchard Pkwy Ste Westminster General Dentist Dr. Thomas Mulheran Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Dr. Tjark R Beaven Walnut Creek Dental Group And Orthodontics CarePOS Town Center Dr Ste Westminster General Dentist Dr. Travis Willey Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Page 17 of 21

26 Dr. Vidhyalakshmi Sampath Bright Now Dental - Westminster ADP # W 104th Avenue Westminster General Dentist C, E1-2 Dr. William J Mcglashan Walnut Creek Dental Group And Orthodontics CarePOS Town Center Dr Ste Westminster General Dentist Dr. Alan N Bernbaum Alan N Bernbaum DDS CarePOS 6654 W 38th Ave Wheat Ridge General Dentist Dr. Christopher Hasselback Comfort Dental - Wheat Ridge ADP # W 26th Ave # Wheat Ridge General Dentist *, **, C, E1-2, E3-4 Dr. David R Maki Aspen Hill Dental, PC ADP # W 38th Ave Wheat Ridge General Dentist *, **, C, E1-2, E3-4 Dr. Lewis Sherman Comfort Dental - Wheat Ridge ADP # W 26th Ave # Wheat Ridge General Dentist *, **, C, E1-2, E3-4 Dr. Sara Marchbanks Comfort Dental - Wheat Ridge ADP # W 26th Ave # Wheat Ridge General Dentist *, **, C, E1-2, E3-4 Dr. William Mcglashan Comfort Dental - Wheat Ridge ADP # W 26th Ave # Wheat Ridge General Dentist *, **, C, E1-2, E3-4 Dr. Eric T Helland Dental Associates At Eagles Nest ADP # Morning Sun Dr Woodland Park General Dentist *, C, E1-2, E3-4 Dr. Gregory E Micheli Dental Associates At Eagles Nest ADP # Morning Sun Dr Woodland Park General Dentist *, C, E1-2, E3-4 Orthodontists Dr. Galen L Callender Galen L. Callender Alpha 7207 Grandview Ave Arvada Orthodontist N/A Dr. James H Mason Colo Orthodontics Alpha 6390 Gardenia St, # Arvada Orthodontist N/A Dr. Jason Messingham Messingham Orthodontics CarePOS 7523 W 80th Ave Arvada Orthodontist N/A Dr. Paul A Hamersky Standley Lake Orthodontics CarePOS 8723 Wadsworth Blvd Ste B Arvada Orthodontist N/A Dr. Amy N Taylor Cornerstar Dental Group And Orthodontics CarePOS 6730 S Cornerstar Way Ste A Aurora Orthodontist N/A Dr. Anne M Abell City Place Modern Dentistry CarePOS E Bayaud Ave Unit H Aurora Orthodontist N/A Dr. Brandy L Burgess Cornerstar Dental Group And Orthodontics CarePOS 6730 S Cornerstar Way Ste A Aurora Orthodontist N/A Dr. James H Mason Colo Orthodontics Alpha 2993 S Peoria St, # Aurora Orthodontist N/A Dr. Jennifer B Berwick Ohmart Orthodontics CarePOS E Smoky Hill Rd Unit Aurora Orthodontist N/A Dr. John Bailey Colo Orthodontics Alpha 2993 S Peoria St, # Aurora Orthodontist N/A Dr. Lisa Austin Bright Now Dental - S. Tower Rd. Alpha 3551 S Tower Rd, #c Aurora Orthodontist N/A Dr. Lisa Austin Bright Now Dental - Smoky Hill Alpha Prospect Ave, Ste #hv2be Aurora Orthodontist N/A Dr. Rhoda L Lockett Lockett Orthodontics CarePOS 1700 S Chambers Rd Aurora Orthodontist N/A Dr. Roy M Lorenz Roy M. Lorenz, DMD, MS Alpha E Hampden Ave # Aurora Orthodontist N/A Dr. Scott W Ohmart Ohmart Orthodontics CarePOS E Smoky Hill Rd Unit Aurora Orthodontist N/A Dr. Theresa L Shaver Front Range Orthodontic Specialists CarePOS E Iliff Ave Ste Aurora Orthodontist N/A Dr. Tuanh Nguyen City Place Modern Dentistry CarePOS E Bayaud Ave Unit H Aurora Orthodontist N/A Dr. Tuanh Nguyen Valley Modern Dentists CarePOS E Quincy Ave Ste B Aurora Orthodontist N/A Dr. John Walker Dr. John Walker Alpha 350 Broadway # Boulder Orthodontist N/A Dr. Robert Hamblin Colorado Dental Health Care Specialists, Pllc CarePOS th St Unit Boulder Orthodontist N/A Dr. Anne M Abell Broomfield Modern Dentistry And Orthontics CarePOS 4490 W 121st Ave Ste Broomfield Orthodontist N/A Dr. Kurt Niepraschk Broomfield Modern Dentistry And Orthontics CarePOS 4490 W 121st Ave Ste Broomfield Orthodontist N/A Dr. Lisa Austin Bright Now Dental - Castle Rock Alpha 1001 S Perry St, #105-A Castle Rock Orthodontist N/A Dr. Paul A Hamersky Colorado Orthodontic Specialists CarePOS 718 Maleta Ln Ste Castle Rock Orthodontist N/A Dr. David E Gold David E. Gold Jr. Alpha 9025 E Mineral Cir # Centennial Orthodontist N/A Dr. Jennifer B Berwick Ohmart Orthodontics CarePOS 7960 S University Blvd Ste Centennial Orthodontist N/A Dr. Scott W Ohmart Ohmart Orthodontics CarePOS 7960 S University Blvd Ste Centennial Orthodontist N/A Dr. Amy N Taylor Prominent Point Dental Group And Orthodontics CarePOS 9625 Prominent Pt Ste Colorado Springs Orthodontist N/A Dr. Bangorn S Terry Smiles For Colorado Orthodontics CarePOS 1539 S 8th St Ste Colorado Springs Orthodontist N/A Dr. Daniel G Snow Snow Orthodontics CarePOS 7560 Rangewood Dr Ste Colorado Springs Orthodontist N/A Dr. David H Schroeder All Smiles Orthodontix CarePOS 3715 Bloomington St Unit Colorado Springs Orthodontist N/A Dr. David Schroeder Apple Orthodontics Alpha 1694 E Cheyenne Mtn Blvd Colorado Springs Orthodontist N/A Dr. Lisa Austin Bright Now Dental - Parkmoor Village Alpha 3208 N Academy Blvd, # Colorado Springs Orthodontist N/A Page 18 of 21

27 Dr. Louis J Taloumis All Smiles Orthodontix CarePOS 3715 Bloomington St Unit Colorado Springs Orthodontist N/A Dr. Louis Talmoumis Apple Orthodontics Alpha 1694 E Cheyenne Mtn Blvd Colorado Springs Orthodontist N/A Dr. Scott Suter Front Range Ortho Alpha 3100 N Academy Blvd, # Colorado Springs Orthodontist N/A Dr. Tuanh Nguyen Falcon Landing Dental Group And Orthodontics CarePOS 7395 N Academy Blvd Colorado Springs Orthodontist N/A Dr. Warren K Johnson Johnson Orthodontics, PC CarePOS Gleneagle Dr Colorado Springs Orthodontist N/A Dr. Warren K Johnson Johnson Orthodontics, PC CarePOS 2190 Academy Cir Colorado Springs Orthodontist N/A Dr. Voytek Bobak Dr. Voytek Bobak Alpha Pleasant Park Rd, #b Conifer Orthodontist N/A Dr. Andrey Nazarov Allegro Orthodontics Alpha 390 S Dayton St Denver Orthodontist N/A Dr. Dori Papir Evergreen Orthodontics CarePOS 1835 S Federal Blvd Ste Denver Orthodontist N/A Dr. Eunice P Lee Hampden Family Dentistry $ Orthodontics Alpha 9250 E Hampden Ave Denver Orthodontist N/A Dr. George F Siersma G Frederick Siersma CarePOS 121 S Madison St Denver Orthodontist N/A Dr. Karen E Franz Stapleton Childrens Dentistry CarePOS 2373 Central Park Blvd Unit Denver Orthodontist N/A Dr. Lia D Baros Orthodontics In The Highlands CarePOS 3538 W 44th Ave Denver Orthodontist N/A Dr. Lisa Austin Bright Now Dental - Denver Downtown Alpha 1955 Arapahoe St, Ste A Denver Orthodontist N/A Dr. Lisa Austin Bright Now Dental - Cherry Creek Alpha 3865 Cherry Creek Dr North, # Denver Orthodontist N/A Dr. Michael D Bellon Dr. Michael D. Bellon Alpha 7200 E Hampden, # Denver Orthodontist N/A Dr. Paul A Rocke Downtown Orthodontics CarePOS 1050 W Colfax Ave Ste G Denver Orthodontist N/A Dr. Lina K Kulkarni Fort Collins Dental Group CarePOS 2310 E Harmony Rd Ste Fort Collins Orthodontist N/A Dr. Lisa Austin Bright Now Dental - Fort Collins Alpha 1217 E Elizabeth St, # Fort Collins Orthodontist N/A Dr. T Allan Hymas Mesa Orthodontics Alpha 1190 Bookcliff, Ave, Ste Grand Junction Orthodontist N/A Dr. Bradley E Goings Skyview Orthodontics Alpha th Ave #a Greeley Orthodontist N/A Dr. David Richter Richter Orthodontics Alpha st Ave Greeley Orthodontist N/A Dr. Gary Barth Dr. Gary Barth Alpha th St #a Greeley Orthodontist N/A Dr. Jared A Ward Greeley Modern Dentistry CarePOS th St Ste Greeley Orthodontist N/A Dr. Shawn Murray Skyview Orthodontics Alpha th Ave #a Greeley Orthodontist N/A Dr. Bryan Nelson Dr. Bryan Nelson Alpha 9567 Suniversity Blvd, #c-1a Highlands Ranch Orthodontist N/A Dr. Kurt Niepraschk Redstone Dental Group/ny Kids Dentist And Orthodontics CarePOS 1165 Sgt Jon Stiles Dr Highlands Ranch Orthodontist N/A Dr. Lisa Austin Bright Now Dental - Highlands Ranch Alpha 3626 Highlands Rnch Pkwy # Highlands Ranch Orthodontist N/A Dr. Paul A Hamersky Douglas County Orthodontics Alpha 9362 S Colorado Blvd, #d Highlands Ranch Orthodontist N/A Dr. Shawn M Murray Murray Orthodontics Alpha 257 Johnstown Center Dr # Johnstown Orthodontist N/A Dr. Howard Stringert Dr. Howard Stringert Alpha 313 W 3rd St, # La Junta Orthodontist N/A Dr. Anne M Abell Crestline Dental Group And Orthodontics CarePOS 5392 S Wadsworth Blvd Unit Lakewood Orthodontist N/A Dr. Jack Allen Jr Dr. Jack M. Allen D.D.S. Alpha 7373 W Jefferson Ave # Lakewood Orthodontist N/A Dr. Kurt Niepraschk Crestline Dental Group And Orthodontics CarePOS 5392 S Wadsworth Blvd Unit Lakewood Orthodontist N/A Dr. Lisa Austin Bright Now Dental - Lakewood Alpha 7611 W Colfax Ave, #d Lakewood Orthodontist N/A Dr. Tuanh Nguyen Crestline Dental Group And Orthodontics CarePOS 5392 S Wadsworth Blvd Unit Lakewood Orthodontist N/A Dr. Voytek Bobak Dr. Voytek Bobak Alpha 1840 S Wadsworth Blvd Lakewood Orthodontist N/A Page 19 of 21

28 Dr. Amir R Fereydouni Kids And Family Dentistry Alpha 40 W Littleton Blvd Littleton Orthodontist N/A Dr. David M Albert David Albert CarePOS 7889 S Lincoln Ct Ste Littleton Orthodontist N/A Dr. Eunice P Lee Southpark Orthodontics Alpha 8199 South Park Lane # Littleton Orthodontist N/A Dr. Jamie Drowley Ohmart Orthodontics CarePOS W San Juan Way Unit Littleton Orthodontist N/A Dr. Jennifer B Berwick Ohmart Orthodontics CarePOS W San Juan Way Unit Littleton Orthodontist N/A Dr. Michael D Bellon Dr. Michael D. Bellon Alpha 7325 S Pierce St, # Littleton Orthodontist N/A Dr. Scott W Ohmart Ohmart Orthodontics CarePOS W San Juan Way Unit Littleton Orthodontist N/A Dr. Theresa L Shaver Front Range Orthodontics Specialists CarePOS 7901 Southpark Plz Ste Littleton Orthodontist N/A Dr. Anne M Abell Lone Tree Dentists CarePOS Commons St Lone Tree Orthodontist N/A Dr. Fazila Durkin Durkin Orthodontics Alpha 7430 Park Meadows Dr Lone Tree Orthodontist N/A Dr. Tuanh Nguyen Lone Tree Dentists CarePOS Commons St Lone Tree Orthodontist N/A Dr. Lisa Austin Bright Now Dental - Longmont Alpha 15 Ken Pratt Blvd, # Longmont Orthodontist N/A Dr. Robert Hamblin Dental Health Of Longmont CarePOS 1260 S Hover St Ste H Longmont Orthodontist N/A Dr. Gary Dixon Smile Zone Orthodontics Alpha 1075 S Boulder Rd, # Louisville Orthodontist N/A Dr. Anne M Abell Loveland Modern Dentistry CarePOS 255 W 64th St Loveland Orthodontist N/A Dr. Stephanie M Ross Loveland Modern Dentistry CarePOS 255 W 64th St Loveland Orthodontist N/A Dr. Fazila H Durkin Palmer Ridge Orthodontics CarePOS 1777 Lake Woodmoor Dr Monument Orthodontist N/A Dr. Andrey Nazarov Allegro Orthodontics Alpha S Progress Way # Parker Orthodontist N/A Dr. Howard Stringert Dr. Howard Stringert Alpha 3955 Sandelwood Lane Pueblo Orthodontist N/A Dr. Jose M Arango Front Range Orthodontic Specialists CarePOS 24 Club Manor Dr Ste Pueblo Orthodontist N/A Dr. Amy N Taylor Marketplace Dental Group And Orthodontics CarePOS 306 Center Dr Superior Orthodontist N/A Dr. Anne M Abell Marketplace Dental Group And Orthodontics CarePOS 306 Center Dr Superior Orthodontist N/A Dr. Brandy L Burgess Marketplace Dental Group And Orthodontics CarePOS 306 Center Dr Superior Orthodontist N/A Dr. Bryan P Nelson Trinity Orthodontics PC CarePOS Colorado Blvd Ste Thornton Orthodontist N/A Dr. Craig A Bahr Comfort Dental Kids North CarePOS 9652 Washington St Thornton Orthodontist N/A Dr. Eunice P Lee Kids And Family Dentistry And Orthodontics Alpha 2300 E 120th Ave # Thornton Orthodontist N/A Dr. Paul A Hamersky Trinity Orthodontics PC CarePOS Colorado Blvd Ste Thornton Orthodontist N/A Dr. William L Lake William L Lake CarePOS 3861 E 120th Ave Thornton Orthodontist N/A Dr. Amy N Taylor Walnut Creek Dental Group And Orthodontics CarePOS Town Center Dr Ste Westminster Orthodontist N/A Dr. Amy N Taylor Orchard Dental Group And Orthodontics Llp CarePOS Orchard Pkwy Ste Westminster Orthodontist N/A Dr. Anne M Abell Walnut Creek Dental Group And Orthodontics CarePOS Town Center Dr Ste Westminster Orthodontist N/A Dr. Anne M Abell Orchard Dental Group And Orthodontics Llp CarePOS Orchard Pkwy Ste Westminster Orthodontist N/A Dr. Brandy L Burgess Orchard Dental Group And Orthodontics Llp CarePOS Orchard Pkwy Ste Westminster Orthodontist N/A Dr. Colin Gibson 1st Impressions Orthodontics Alpha 1333 W 120th Ave # Westminster Orthodontist N/A Dr. Gary Dixon Smile Zone Orthodontics Alpha 9910 Wadsworth Pkwy Westminster Orthodontist N/A Dr. Lisa Austin Bright Now Dental - Westminster Alpha 3003 W 104th Avenue Westminster Orthodontist N/A Page 20 of 21

29 Dr. Stephanie M Ross Orchard Dental Group And Orthodontics Llp CarePOS Orchard Pkwy Ste Westminster Orthodontist N/A Dr. Bradley E Goings Windsor Smiles Orthodontics Alpha 1218 W Ash St Unit D Windsor Orthodontist N/A Dr. David Richter Richter Orthodontics Alpha 1218 W Ash St Windsor Orthodontist N/A Dr. Shawn Murray Windsor Smiles Orthodontics Alpha 1218 W Ash St Unit D Windsor Orthodontist N/A General Provisions: All needed specialty care (except Orthodontics) that cannot be provided by your selected General Dentist can be provided by a plan participating specialist. These specialists have been contracted to offer plan members up to a 20% discount off of their normal full fee. You may see any of the contracted plan specialists as the needed without contacting your selected General Dentist. Call us at or for a list of plan participating specialists or visit our web site at Orthodontic treatment discounts are listed on your plan schedule of benefits. All family members must see the same General Dentist for treatment. You may change your General Dentist selection at any time by contacting us at or Some large dental offices with multiple locations list all contracted providers from all locations combined. They do this because some of the providers float between offices as needed. Please contact the dental office for the specific providers at that location. Code Definitions: * - This office provides nitrous oxide. C - This office accepts most children over the age of 4 for routine care. Please check with your selected dental office for their specific guidelines. E1-2 - This office will provide most 1 and 2 canal root canal procedures depending on the complexity of the situation. E3-4 - This office will provide most 3 and 4 canal root canal procedures depending on the complexity of the situation. N - This office will only see members that are identified on the eligibility roster provided by the plan administrative office at the beginning of each month. ** - Estos consultorios tienen personal de habla hispana. Page 21 of 21

30 Please note: TO FIND A CONTRACTED CarePOS DENTIST IN YOUR AREA VISIT: and click on the Provider Locator link the quick links box. Then go to the Careington logo and click on the logo. Then enter your zip code. FOR THE FULL CarePOS FEE SCHEDULE IN YOUR AREA VISIT: and click on the All Plan Fee Schedule link in the quick links box. Then go to the Careington POS Fee Schedule box and enter your zip code. Your zip code specific fee schedule will appear in a PDF format. You will then be able to open the PDF file showing the discounted fees in your area. The CarePOS dental plan is a discount fee for service dental plan and is in no way considered insurance.

31 Beta Health Association, Inc. Dental Plan Specialists since 1990 Check out these Free National Discount Programs! All employees and dependents enrolling in one of the attached dental plans can use any of the attached programs free of charge. It is our thanks to you for using Beta Health as your dental carrier! Simply follow the instructions on the attached discount program description sheets.it s that easy. You can photocopy these items and distribute to all of your dependents as well. If you have questions, please call Beta Health at or

32 Introducing Discount Services for Dental Plan Members Free of Charge The Vision Discount Plan Beta Health Association, Inc. has teamed up with EyeMed Vision Care to offer easy access to over 43,000 national, conveniently located vision care providers including optometrists, ophthalmologists, opticians and many leading optical retailers, such as LensCrafters, Target Optical, and most Sears Optical and Pearl Vision locations. This benefit is free of charge for Beta Health Dental Plan members. Note that this is not insurance, only a discount plan to save you and your family members $ as needed! Vision Care Services Exam with Dilation (as necessary) Contact Lens Fit and Follow-up Standard Premium In Network Only $5 off exam $10 off exam $10 off exam Frames When a complete pair of glasses is purchased (frame, lenses and lens options purchased in the same transaction) a 35% discount will apply.* Standard Plastic Lenses Member Pays Single Vision $50 Bifocal $70 Trifocal $105 Lens Options Member Pays UV Coating $15 Tint (Solid and Gradient) $15 Standard Scratch Resistant Coating $15 Standard Polycarbonate $40 Standard Anti-Reflective Coating $45 Standard Progressive (Add-on to Bifocal) $65 Other Add-ons and Services 20% off retail Contact Lens Materials (Discount applied to materials only) Conventional 15% off retail price Disposable no discount Laser Vision Correction** Lasik or PRK Frequency Examination Frame Lenses or Contact Lenses 15% off retail price or 5% promotional price Unlimited Unlimited Unlimited * Items purchased separately will be discounted 20% off of the retail price. ** Since Lasik or PRK vision correction is an elective procedure, performed by specially trained providers, this discount may not always be available from a provider in your immediate location. For a location near you and the discount authorization, please call LASER6.

33 Introducing Discount Services for Dental Plan Members Free of Charge The Hearing Discount Plan This hearing care program combines unlimited choices with quality and value. It s provided free of charge to all employees and family members enrolled in a Beta Health Association, Inc. dental plan. Beta Health and EPIC Hearing Health Care give you easy access to a large national network of thousands of hearing care professionals primarily physicians and audiologists who can help you achieve your maximum hearing potential throughout your life. The prices you get from EPIC may be as much as 50% below the manufacturer s suggested retail price and up to 35% lower than most discount offers. EPIC can coordinate the coverage with your existing healthcare plan. Note that this is not insurance, only a discount plan to save you and your family members $ as needed! To activate your hearing discount plan, call EPIC Hearing Health at EPIC will send you a card with all the information you need to access your benefits, including referrals to providers near you and activation forms to access them. Tell them that you are a Beta Health member and you will be connected to a personal EPIC phone contact who can answer any questions you may have. A booklet that outlines the plan benefits (as well as pricing) will be mailed to your home. Then you will follow through with an appointment, examination and treatment. All payments should be made to EPIC HSP. No other billing or payments should occur. Contact EPIC at any time for assistance, advice and information. Check out these benefits and savings! The hearing discount plan benefits and savings are: Hearing tests Hearing aids, aid cleaning supplies, accessories and batteries Ear protection, swim and musician earplugs Assistive listening devices TV ears (amplifies and clarifies television) Alerting and signaling devices The Prescription Drug Discount Plan Do you want to SAVE an average of 10% to 85% on the cost of prescription medications? With the HealthTrans nationwide national discount prescription drug program this is easy! It s simply a great way to save money on prescription drugs! After working closely with pharmacies and drug manufacturers, HealthTrans has negotiated lower prices for thousands of medications, and have passed these savings on to all Beta Health Association members and their families. The average discounts range from up to 16% on brand name and up to 55% on generic drugs. There are no limits on quantities and no paperwork to complete. Discounts are available at over 55,000 pharmacies nationwide and are also available to the entire family on an as needed basis! To use your HealthTrans discount drug card: 1.) Write in your specific member I.D. number on the member I.D. cards (attached) for use at the pharmacy. 2.) Take your card and prescription(s) to a participating pharmacy. Pharmacy locations can be found at the web site below. 3.) Pay the pharmacy the negotiated reduced discount! Note that this is not insurance, only a discount plan to save you and your family members $ as needed! See how much you can save today by going to

34 Thank you for choosing Beta Health Association, Inc. as your dental partner. We are proud to offer you, free of charge, the EyeMed Vision Discount Plan, the Epic Hearing Health Plan and the HealthTrans Prescription Discount Plan. Please use the ID cards provided below to access these Free of Charge benefits. Follow all instructions as identified on each set of cards. We appreciate our relationship! EyeMed Group Number: Group Name: Beta Health Association, Inc. Member Name: EyeMed Group Number: Group Name: Beta Health Association, Inc. Member Name: Call to locate the nearest EyeMed Provider. This is a discount program and not insurance. Call to locate the nearest EyeMed Provider. This is a discount program and not insurance. Epic Hearing: Call for ID card information. Group Name: Beta Health Association, Inc. Member Name: Epic Hearing: Call for ID card information. Group Name: Beta Health Association, Inc. Member Name: This is a discount program and not insurance. This is a discount program and not insurance. BIN #: Group ID: DDS01 Member ID: Please enter your initials & the last four digits of your phone #) Member Name: This is a discount program and not insurance. Visit for more information or call BIN #: Group ID: DDS01 Member ID: Please enter your initials & the last four digits of your phone #) Member Name: This is a discount program and not insurance. Visit for more information or call

35 COMBINED DENTAL EMPLOYEE ENROLLMENT FORM Please complete the form following this page and submit to personnel at your earliest convenience. Note that since this is an annual open enrollment, all employees must either enroll or waive for the next year. A REMINDER! You will not be allowed to enroll in any plans again until this time next year.

36 9725 E Hampden Avenue #400 Denver, CO (Phone) (Fax) TO BE COMPLETED BY EMPLOYER ADP/POS GROUP ENROLLMENT, WAIVER, AND CHANGE REQUEST FORM New Employee COBRA Name of Employer (Use Name from Group Billing Notice or Master Application) Change Address Change Dependent Status Terminate* * Can only terminate at open enrollment or if employment is terminated. Beta Health Group # THREE TIER TO BE COMPLETED BY EMPLOYEES ELECTING TO ENROLL Social Security Number Effective Date Month Day Year Date of Hire Month Day Year Date of Birth Month Day Year Phone # Work: Home: Your Name Last First M.I. Gender Female Male Marital Status Single Married Your Home Address Address: City State Zip Code Dental Options (please check your selection) Alpha Dental Plan only** Provider Selection: ADP # CarePOS Dental Plan only **You must select a plan provider for all services. Please visit for a current provider directory. The Alpha and CarePOS dental plan options are discount fee for service dental plans and are in no way considered insurance. Alpha Dental providers can be changed at any time by calling or COMPLETE FOR DENTAL Is your spouse to be enrolled? Yes No Enrollment Selection (Check the Correct Box Below): Employee Only Employee Employee Plus One Plus Two or more Are you enrolled in any other dental plans? Yes No Complete for Dependent(s) Full-time Gender Do any of your dependents have any other Spouse Name (Last) (First) (Middle Initial) Student Y/N Date of Birth M or F dental plan? If Yes, Name of Carrier D E P E N D E N T (S) / / Yes No / / Yes No / / Yes No / / Yes No / / Yes No / / Yes No / / Yes No DENTAL PLAN WAIVER I have been offered the above dental plan options and I am declining participation at this time. I also understand that the next time that I may enroll in one of these plans is at the next open enrollment period only (one year from now). The only exception to this is if a qualifying event occurs. Date Signature of Employee It is unlawful to knowingly provide false, incomplete, or misleading facts on this form or to defraud or attempt to defraud Beta Health or one of their partners. Penalties may include imprisonment, fines, denial of services and civil damages. Please report any organization or agent who you feel knowingly provides false, incomplete or misleading facts for the purpose of defrauding the participants to the Colorado Division of Insurance. I also agree to remain on the plan for a minimum of one year or until the next open enrollment period (which ever comes first). The only exception to this is if I loose employment (either voluntarily or involuntarily). Date Your Signature X 10/08