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The Crown Dental Plan
for Branch 41 Members

320 South Service Road - Suite L
Melville, New York 11747
Tel: 516-349-7470
Fax: 516-349-7434

Dear NALC Branch 41 Members:

In order to use this plan you must submit an application for Crown Dental to Branch 41. Membership in this plan is pre-paid by Branch 41. All dues paying members in"GOOD STANDING" are eligible to participate in the Crown Dental Plan.

Once you complete your application mail it to

Branch 41
2262 Bath Avenue
Brooklyn NY 11214.

Once approved you will receive your Membership Card, a copy of the Fee Schedule and a Directory of Participating Providers.

Your membership in the Crown Dental Plan gives you access to a network of qualified Dentists, who will provide you with Free Examinations & X-rays and reduced fees for all other services that are at least 25% lower than the fees they charge their existing patients. You will see these fine dentists in their private offices. There are no restrictions to the services provided - No pre-Certification is required and there are no Pre-Existing condition eliminations.

We suggest that you identify yourself as a Crown Dental member when you make your appointment and once again when you arrive at the participating Dentist's office. It is always in your best interest to discuss the proposed treatment and the charges before treatment has begun. By doing so, you will be assured of receiving the service you require at the agreed upon cost.

Should you have any questions, or if we can assist you in any way please feel free to call us. We welcome you and look forward to serving your needs.

Sincerely,

Martin C. Sussman

President

Crown Dental Enrollment Application
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