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First Name (required)

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Last Name (required)

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Dental License Number and State* (required)

Please note: In order to reasonably assure that there are no interlopers on our site we verify all person's license number with their state Boards. Because of this we ask for accurate spelling and license numbers including any letters associated with it. Also, it may take up to 24 hours for this verification process to be completed. Please be sure to follow through with the second step of the registration process by responding to the automated approval notice. Thanks

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Country (required)

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State (required)

State/Province/Region

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Other State/Province/Region

Please enter your location if you selected "other".

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Nickname (required)

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Volunteering

Are you interested and available to volunteer? Our goal is for this site to be a resource for finding, reporting experiences, and evaluating volunteer opportunities locally and around the world. Please check the type of opportunity you're interested in.

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Mentor (required)

Available to be a mentor? Select 'Yes' if you would like to be included on the list of available mentors. This will put your name, city, state and bio on the list of ARD dentists interested in being mentors to other ARD dentists. Your email address will not be visible, but registered dentists will be able to email you through the ARD site.

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Per Diem (required)

Select 'Yes' if you would like to be on the list of ARD members available to be contacted for per diem work. Be sure to set the visibility of the State field to "All Members".

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