You have been approved to enroll in the DentCentive Program! Start earning extra cash now!

  1. Complete Enrollment form below.
  2. Enroll in the DentCentive text balance feature if you would like to receive text messages following transactions on the card.
  3. Draw signature in E-Signature box.
  4. Click Submit Form, to enroll and receive confirmation.
<script type="text/javascript" src=""></script><noscript><a href="" title="Online Form">Online Form - DentCentive Enrollment - (no W9)</a></noscript>