Smile Easy Dental Plan -MI

Enjoy 2 Free Cleanings Per Year & Discounts Up To 30% in our MI Offices

We offer an easy way for patients to receive comfortable, convenient care with the help of our in-house Smile Easy Dental Plan. It’s easy to get started – just fill out the application below and one of our associates will be in touch to finalize your membership!

Annual Premiums

$325 for first member
$249 each additional

Annual Benefits

2 Regular Cleanings (absence of periodontal disease)
If you receive periodontal therapy, you will receive one periodontal cleaning annually at no charge. (D4910)
2 Periodic Dental Exams
1 set of Check Up X-Rays & any individual X-rays needed throughout the year
30% Savings on Implant Placement (implants, abutments, attachments, bone grafts)
15% Savings on Clear Aligner Therapy
30% Savings on products – some exclusions may apply, call for details.
30% Savings on Fillings, Crowns, Veneers, Root Canals, Extractions, Dentures/Partials, Periodontal Treatment
30% Savings on in-office Boost Teeth Whitening

How much can you save?

Michigan Pricing – PDF Download

Effective Date*
MM slash DD slash YYYY
Preferred Office Location*
Member Name*
First Last
Address*
Street Address City State ZIP Code
Date of Birth*
MM slash DD slash YYYY
Email*
Home Phone*
Cell Phone*
Gender*
Number of Eligible Dependents*
Please enter a number from 0 to 6.
Have more than 6 eligible dependents? Please contact us for assistance.
Dependent 1 Name*
Dependent 1 Gender*
Dependent 1 Date of Birth*
MM slash DD slash YYYY
Dependent 2 Name*
Dependent 2 Gender*
Dependent 2 Date of Birth*
MM slash DD slash YYYY
Dependent 3 Name*
Dependent 3 Gender*
Dependent 3 Date of Birth*
MM slash DD slash YYYY
Dependent 4 Name*
Dependent 4 Gender*
Dependent 4 Date of Birth*
MM slash DD slash YYYY
Dependent 5 Name*
Dependent 5 Gender*
Dependent 5 Date of Birth*
MM slash DD slash YYYY
Dependent 6 Name*
Dependent 6 Gender*
Dependent 6 Date of Birth*
MM slash DD slash YYYY
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.

Summary of Savings and Discounted Fees

Diagnostic & Preventative

ADA Code

Description of Services

Member Pays

Regular Price

Savings

0120

Periodic Oral Evaluation - Established Patient

No Charge

$66.00

0140

Limited oral evaluation- problem focused

No Charge

$101.00

0150

Comprehensive Oral Evaluation- new or established patient

No Charge

$116.00

0210

Full mouth x-rays

No Charge

$172.00

0220

First film

No Charge

$39.00

0230

Each additional film

No Charge

$34.00

0272

Bitewings- two films

No Charge

$60.00

0274

Bitewings - four films

No Charge

$85.00

0330

Panoramic Film

No Charge

$148.00

1110

Prophylaxis (cleaning) adult

No Charge

$118.00

1120

Prophylaxis (cleaning) child

No Charge

$92.00

1206

Topical application of fluoride varnish

$40.00

$57.00

$17.00

1208

Topical application of fluoride

$39.00

$55.00

$16.00

1351

Sealant- per tooth

$50.00

$72.00

$22.00

Restorative - Fillings

ADA Code

Description of Services

Member Pays

Regular Price

Savings

2330

Composite- one surface, anterior

$158.00

$225.00

$67.00

2331

Composite- two surfaces, anterior

$182.00

$260.00

$78.00

2332

Composite- three surfaces, anterior

$224.00

$320.00

$96.00

2391

Composite- one surface, posterior

$166.00

$237.00

$71.00

2392

Composite- two surfaces, posterior

$209.00

$299.00

$90.00

2393

Composite- three surfaces, posterior

$260.00

$371.00

$111.00

Restorative - Crowns

ADA Code

Description of Services

Member Pays

Regular Price

Savings

2740

Crown-porcelain/ceramic substrate

$1047.00

$1496.00

$449.00

2750

Crown-porcelain fused to high noble metal

$1046.00

$1494.00

$448.00

2751

Crown-porcelain fused to base metal

$930.00

$1329.00

$399.00

2920

Recementation - crown

$103.00

$147.00

$44.00

2950

Core Buildup

$265.00

$379.00

$114.00

2954

Prefabricated post and core

$307.00

$438.00

$131.00

Endodontics - Root Canals

ADA Code

Description of Services

Member Pays

Regular Price

Savings

3310

Root Canal (anterior)

$675.00

$964.00

$289.00

3320

Root Canal (bicuspid)

$781.00

$1116.00

$335.00

3330

Root Canal (molar)

$945.00

$1350.00

$405.00

Periodontics

ADA Code

Description of Services

Member Pays

Regular Price

Savings

4341

Periodontal scaling and root planing- 4 or more teeth per quadrant

$232.00

$332.00

$100.00

4355

Full mouth debridement

$169.00

$242.00

$73.00

4381

Localized delivery of antimicrobial agents

$39.00

$55.00

$16.00

4910

Periodontal maintenance

$183.00

$261.00

$78.00

Prosthodontics - Dentures & Bridges

ADA Code

Description of Services

Member Pays

Regular Price

Savings

5110

Complete denture - maxillary (upper)

$1626.00

$2323.00

$697.00

5120

Complete denture- mandibular (lower)

$1630.00

$2328.00

$698.00

5213

Partial denture - maxillary (upper)

$1588.00

$2268.00

$680.00

5214

Partial denture - mandibular (lower)

$1674.00

$2391.00

$717.00

5225

Partial denture - flexible base- maxillary (upper)

$1411.00

$2015.00

$604.00

5226

Partial denture - flexible base- mandibular (upper)

$1403.00

$2004.00

$601.00

Bridge - Fixed

ADA Code

Description of Services

Member Pays

Regular Price

Savings

6240

Pontic-porcelain fused to high noble metal

$1028.00

$1468.00

$440.00

6241

Pontic-porcelain fused to base metal

$955.00

$1364.00

$409.00

6245

Pontic-porcelain/ceramic

$1028.00

$1468.00

$440.00

6740

Crown-porcelain/ceramic

$1039.00

$1484.00

$445.00

6750

Crown-porcelain fused to high noble metal

$1028.00

$1468.00

$440.00

Oral - Surgery

ADA Code

Description of Services

Member Pays

Regular Price

Savings

7140

Extraction, erupted tooth

$161.00

$230.00

$69.00

7210

Surgical removal of erupted tooth

$252.00

$360.00

$108.00

7220

Removal of impacted tooth- soft tissue

$287.00

$410.00

$123.00

7230

Removal of impacted tooth- partially bony

$359.00

$513.00

$154.00

7240

Removal of impacted tooth- completely bony

$435.00

$622.00

$187.00

Orthodontics

ADA Code

Description of Services

Member Pays

Regular Price

Savings

8090

Invisalign

$3895.00

$5564.00

$1669.00

Other Services

ADA Code

Description of Services

Member Pays

Regular Price

Savings

9910

Application of desensitizing resin

$57.00

$81.00

$24.00

9944/9945

Occlusal guard by report

$588.00

$840.00

$252.00