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Forms & Books > Claim Forms & Envelopes > Dental Claim Forms > 1994 Dental Claim Forms >

Medical Arts Press® 1994 Dental Claim Form; Snap-Apart, No Imprint

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Item # 174-29406


$39.99
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1994 ADA approved form with provider I.D. #, additional coverage information, dental plan I.D. #, new signature wording and new payment by other plan area. 2-part carbonless duplicating stock. 500 per package. Size: 8-1/2x11".
Product Information
Form Type :
Insurance
Format :
Dental Claim Form
Sheet Size :
8-1/2" x 11"
Form Size :
8-1/2" x 11"
Media Quantity :
500
Binding Type :
Loose
Paper Color :
White
Number of Parts :
2
Carbonless :
No
# Up Per Sheet/Page :
1
NCR Paper :
No
Numbered :
No
Holes Punched :
None
Personalization :
No
Security Features :
No
Miscellaneous
Brand Name :
Medical Arts Press
Country of Origin :
USA
Weight
Weight :
8.90 lbs. per Box
Description Price Unit Take Action
Medical Arts Press® Dental Insurance Signature Labels; 1994
Medical Arts Press® Dental Insurance Signature Labels; 1994

174-20298

 $18.00
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