Purchase a Carolina Complete Dental Prime Membership

Here at Carolina Complete Dental, we know your family’s health and happiness is your top priority—because it’s ours, too. We believe dental care should be accessible and affordable to everyone, but if you don’t have insurance, obtaining dental care can be a real challenge and source of stress. That’s why we are excited to offer the Carolina Complete Dental Prime Membership! We’re proud to offer quality dental care with a friendly smile, and a spot in our dental family.

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Contact Information

Name*

First Last

Email*

Membership Plan Options

Choose Your Plan*

Single Person ($35/mo.)

2 People ($68.50/mo.)

Periodontal Plan Only ($68.33/mo.)

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Single Plan Cost

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2 People Plan Cost

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Periodontal Plan Cost

(*Perio plan includes 4 perio maintenance cleanings per year)

Add Additional People On Your Plan?

Yes

Number of Additional People On Your Plan*

Each additional person on your plan is $20.85/mo.

People on the Plan*

Please list all people on this plan. Use the plus symbol to add another person.

Name

Birth Date

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Additional People Total Cost*

Payment Information

Would You Like to Pay Monthly or Annually?*

Monthly

Annually

Total Monthly Membership*

Price: $0.00

Total Annual Membership*

Price: $0.00

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Annual Membership Adjustment

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Annual Membership Adjustment (Perio)

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Purchase a Carolina Complete Dental Prime Membership

Contact Information

Membership Plan Options

Payment Information