Become a Provider

Complete the online application to join the NobleDentist community of participating dentists in Australia.

Become a Provider

This application is for dentists and specialists interested in becoming providers within the NobleDentist community.

There are several great reasons for becoming a provider. Below are just some of those reasons.

Receive new patients - we receive visitors to the website from all over Australia looking for their nearest provider.
Have an online presence - 1000s of people every month will see you on the internet via the NobleDentist website.
Increase treatment acceptance - members have paid for their membership because they are motivated to accept treatment.
Receive high-end work - 76% of our members are seeking expensive dental treatment including cosmetic dentistry.
Remain in contact with members - email messages regarding dentistry are sent to members every 3 months.
Retain members - members including their families should be loyal to you for at least the term of their membership.

If you are interested, simply email NobleDentist. Our contact details can be located by clicking on Contact Us.

If you are certain that you wish to be a provider then simply complete this online application to commence the application process. Multiple applications will need to be completed in the case that several dentists in one practice wish to join the NobleDentist community.

Your application will be expedited by submitting this online application.

Participating Dentist Application

Practice Address
Dental practice name
Principal dentist full name
Applicant dentist full name
Specialty
Provider number
Professional indemnity insurance	Yes No
Street
Suburb
State
Post Code
Telephone
Fax
Mobile
Email
Website	http://
Photograph	(jpeg file only)
Provider password
Confirm provider password