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Membership Info, Costs and Sign Up   Mainline Dental Plan Annual Fees Single $102.00 *Member & Spouse (or domestic partner) $132.00 Parent/child (under age 18) $132.00 *Family $156.00 **Group Please call for a quote! *Family Membership: Family coverage includes member, spouse or domestic partner, and all children under the age of 18 residing in the same household. *Group Membership: Group coverage can be provided for employers with 4 or more employees. Please call our office for a quote. Membership fee is paid on an annual basis. Online Application Form (through our secure server) Printable Application Form Cancellation Policy   Please mail completed application form to: Mainline Dental Plan, Inc. 9 Furler Street Totowa, NJ 07512 Phone: 1- 877- 880- PLAN (7526) Fax: (702) 880-7531