Check Eligibility for Free Dental Care

Welcome to Healthy Smiles!

We're excited to help you and your child with dental services. To check your eligibility to receive services at Healthy Smiles, please fill out the form below. A member of our staff will reach out to you directly to discuss your eligibility and learn more about your needs.

Parent First Name Parent First Name is required

Parent Last Name Parent Last Name is required

Phone Number Please enter a 10 digit phone number

Email Address Please enter a valid email address

Does your child have dental insurance? Yes No

Does your child have dental insurance? is required

Does your child have Medicaid? Yes No

Does your child have Medicaid? is required

Check Eligibility for Free Dental Care

Welcome to Healthy Smiles!

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