Delta Dental of Kentucky 

Dentist Change Request Form

Thank you for being a participating provider! If you need to add a provider, remove a provider, or notify us of a location change please complete the form below.  For changes regarding EFT, please visit Dental Office Toolkit.

Questions? Please contact us.

ProviderRelations@deltadentalky.com

P: 800-955-2030

F: 877-224-2441