LIBERTY DENTAL NEW YORK IPA, LLC IPA PARTICIPATING PROVIDER AGREEMENTParticipating Provider Agreement • November 17th, 2020 • New York
Contract Type FiledNovember 17th, 2020 JurisdictionThis Provider Agreement (the “Agreement”) is made and entered into by and between LIBERTY Dental Plan New York, IPA LLC. (“LIBERTY IPA”) and [legal name of dental office]: