Dentists

Forms & Resources

For your convenience, we’ve posted forms and documents that you and your staff commonly use in your day-to-day transactions with us. Simply click on the link to open the PDF and download the form.

The Altus Dental payer ID number is 50503

To join Altus Dental, simply return a completed Dentist Credentialing Packet.
Dentist Credentialing Packet
Rhode Island Dentist Credentialing Packet

This list details all the forms you need to submit your application package.
Enrollment Checklist

To add or change a dentist at a location, complete and return a Change/Add Location Form.
Change/Add Location Form

Use this form if your practice has had a change in address.
Address Change Form

To remove a dentist from a location, return a completed Remove Dentist from Location Form.
Remove Dentist from Location

To inform us of the Sale of a dental practice, complete and return a Sale of Dentist Practice Form.
Sale of Dentist Practice Form

Return a completed W-9 form along with the appropriate forms.
W-9 Form

View our check processing dates.
Check Run Schedule