TMPPM 2010 > Volume 1, General Information > Section 6: Claims Filing > 2006 American Dental Association (ADA) Dental Claim Filing Instructions > 2006 ADA Dental Claim Form


6.7.3 2006 ADA Dental Claim Form

A sample of the ADA Dental Claim form can be found on the ADA website at

Texas Medicaid & Healthcare Partnership
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