We can only file a claim in certain states.  We need to know WHERE your loss occurred.

Question 3 of 3

Did your tooth loss occur in any of the following States?       YES       NO   

Arkansas
Connecticut
District of Columbia
Florida
Maine
Maryland
Massachusetts
Minnesota
Missouri
Montana
New Hampshire
Nebraska
New Mexico
New York
North Carolina
North Dakota
Rhode Island
South Carolina
South Dakota
Vermont
Washington
Wisconsin
Wyoming