Membership Info

Annual Subscription
Single Member $102.00
Member and Spouse (or domestic partner) $132.00
Parent/Child $132.00
*Family $156.00
Semi-annual Subscription
Single Member $51.00
Member and Spouse (or domestic partner) $66.00
Parent/Child $66.00
*Family $78.00
Quarterly Subscription
Single Member $25.50
Member and Spouse (or domestic partner) $33.00
Parent/Child $33.00
*Family $39.00
*Family includes: Member, spouse and all dependent children under 18 years of age.


Please mail completed application form to:


Mainline Dental Plan, Inc.
9 Furler Street
Totowa, NJ 07512

Phone: 1- 877- 880- PLAN (7526)
11am – 8pm EST
Fax: (702) 880-7531

Single Membership:

  • Single coverage is for the member only.

Member & Spouse

  • Includes member and spouse or domestic partner residing in the same household.

Parent/Child:

  • Parent/Child coverage includes member and 1 child under the age of 18 residing in the same household.

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.