Sioux City Family Dentistry
Smile Savers Plan
Cost-Saving Dental Discount Plan
Membership Types
Single Membership – $390
Includes 2 routine dental cleanings and 1 fluoride application, 2 doctor’s exams, and unlimited necessary x-rays per membership year.
Dual Membership – $705
Parent/Child or spouses only
Periodontal Maintenance Membership – $690
Includes 3 periodontal maintenance visits (periodontal maintenance cleaning and fluoride), 2 doctor’s exams, and 1 set of necessary x-rays per membership year.
Treatment Covered:
| DIAGNOSTIC AND X-RAYS | |
| Comprehensive exam (new patient) | 100% |
| Periodic exam (2 per year) | 100% |
| Limited oral exam (1 per year) | 100% |
| 1 set of bitewings per year and up to 3 periapicals | 100% |
| FMS or panoramic (1 every 5 years) | 100% |
| PREVENTATIVE | |
| Child/Adult prophylaxis (2 per year) | 100% |
| Fluoride Varnish (1 per year) | 100% |
| Sealants | 15% |
| ALL OTHER PROCEDURES | |
| Crowns, Fillings, Periodontics, Veneers, etc | 15% |
To Enroll:
- Fill out an enrollment form in our office
- Have payment ready when you turn in your enrollment form
Plan Guidelines:
- Non-refundable
- The patient’s portion of the bill is due on the day of services
- There is no maximum to the number of dental services that this policy will cover
- Can only be used for services in this office
*** This is NOT dental insurance and can only be used by those who do not have dental insurance at this dental office. This plan does not cover injuries due to workers’ compensation or for costs covered under automobile insurance.