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Upload a copy of your current dental license. Accepted formats: PNG, JPEG, GIF, BMP, TIFF, or WebP images, PDF, or Word/ODT documents (.doc, .docx, .odt).
Your license must be current. Enter a date in the future.
These must match your EXACT NPI registration. Look up your NPI for FREE https://npiregistry.cms.hhs.gov/search The practice name will also be used in SmileDx unless you choose a different name below.
The address registered with your NPI.
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