div class=ts-pagebutton class=gotoPage data-page=1Page 1button div class=ts-imageimg data-url=i-authorize-and-request-my-insurance-company-to-pay-directly-to-the-dentist-or-dentalhtmlpage=1 data-page=1 class=ts-thumb lazyload alt=Page 1: €¦ · I authorize and request my insurance company to pay directly to the dentist Or dental group insurance benefits otherwise payable to me I understand that the patient portion loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentsnetreader033viewer2022051922600fa1dda750cf025917b266html5thumbnails1jpg width=140 height=200 divdiv