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1The plan is administered by Dominion Dental Services, Inc., which operates under the trade name Dominion National. Benefit limits and cost-shares apply. Members may choose to receive treatment from a non-participating dentist, but may pay higher costs for services and are responsible for any cost above the Maximum Allowable Charge (MAC) charged by the non-participating dentist. Benefit limits and cost-shares apply.
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Last updated: 10/15/2022