Become An IndepenDENT Dental Solutions Member

 

Please fill out the application form below. Once we have received your membership application, you will receive an email from our team with a link to a brief survey, that will help us get to know more about you and your practice. The information provided will help us ensure we are best meeting the unique needs of your practice.

Over the next 24 to 48 hours, we will be working alongside Midway Dental to get your account set up to include the IDS-exclusive pricing. Once your account set up is complete, we will reach out and provide you with your account information, including the account number and sales representative who will be supporting your practice. We will also include a copy of our welcome packet that provides and overview of all the savings opportunities available to you as well as instructions on how to take full advantage of your membership.

  • Please note, if you are an Illinois practice, please note you must first be an ISDS member to join IDS.
  • Prior to submitting your application, please take a moment to review our IDS Member Services Agreement (MSA).

‚ÄčIf you have questions or need assistance with the form, please contact us.

Membership Form

IDS Membership Application

Primary Doctor's Information

Office Address

Office Manager and/or Ordering Personnel's Contact Information

Same as Doctor's Office

Account Information

How would you like your account setup? (For multiple locations only)

Referral Information

How did you hear about us? *
If you selected "Midway Dental", please indicate which Midway representative below.

Terms and Conditions

MSA *