Delta Dental of New Mexico

Forms

Mail completed paper claims to:
 
Delta Dental of New Mexico
2500 Louisiana Blvd. NE, STE. 600
Albuquerque, NM 87110
  • Provider Association Form: Active Delta Dental Participating Providers can use this form to add a new office location without needing to fill out the full Provider Credentialing Profile.
  • Practice Information Update Form: Use this form to notify Delta Dental of New Mexico about changes to practice information, such as the street address or office hours.
  • Provider Termination Form: Use this form to notify Delta Dental of New Mexico about a provider who is no longer working at your practice.

Oral Health Posters

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