Delta Dental of New Mexico


At Delta Dental, we want to make selling our products as simple as possible. We have made available for download important forms to ensure you have everything you need just a click away.

Agent Agreement Packet 

Agent Agreement Addendum

Form W-9 

  • Note: You can fill out most of this form on a computer. However, you will need to print it, sign it, and then return a paper or scanned copy to Delta Dental of New Mexico.

Individual Authorization Form

ACH Authorization

Claim Form

Mail completed claims to:
Delta Dental of New Mexico
2500 Louisiana Blvd. NE, STE. 600
Albuquerque, NM 87110

If the information you are looking for is not available here, contact your Account Manager.

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