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You’ve been selected to join the DSSN Ambassador Program!Please complete the short form below to confirm your details and finalize your onboarding.
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Name
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Email
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Marketing Consent
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By providing your number, checking this box, and clicking “Submit” at the end of the application, you consent to receive recurring automated promotional and marketing messages from Dental Success Network and agree to our
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Do you reside in the United States?
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Are you a Dental Student or Resident?
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Dental Student
Resident
Upload Student ID
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Max. file size: 128 MB.
Enter Student ID Number
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Enter Dental License
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Name of Dental School
(Required)
Arizona School of Dentistry & Oral Health (ATSU), Mesa, AZ
Boston University Henry M. Goldman School of Dental Medicine, Boston, MA
California Northstate University College of Dental Medicine, Elk Grove, CA
Case Western Reserve University School of Dental Medicine, Cleveland, OH
Columbia University College of Dental Medicine, New York, NY
Creighton University School of Dentistry, Omaha, NE
Dalhousie University Faculty of Dentistry, Halifax, NS
East Carolina University School of Dental Medicine, Greenville, NC
Harvard University School of Dental Medicine, Boston, MA
Herman Ostrow School of Dentistry of USC, Los Angeles, CA
High Point University School of Dental Medicine and Oral Health, High Point, NC
Howard University College of Dentistry, Washington, DC
Indiana University School of Dentistry, Indianapolis, IN
Kansas City University College of Dental Medicine, Joplin, MO
LECOM School of Dental Medicine, Bradenton, FL
Lincoln Memorial University College of Dental Medicine, Knoxville, TN
Loma Linda University School of Dentistry, Loma Linda, CA
Louisiana State University Health Sciences Center School of Dentistry, New Orleans, LA
Lyon College School of Dental Medicine, Batesville, AR
Marquette University School of Dentistry, Milwaukee, WI
McGill University Faculty of Dentistry, Montréal, QC
Medical University of South Carolina College of Dental Medicine, Charleston, SC
Meharry Medical College School of Dentistry, Nashville, TN
Midwestern University College of Dental Medicine, Downers Grove, IL
Midwestern University College of Dental Medicine, Glendale, AZ
Missouri School of Dentistry & Oral Health at ATSU, Kirksville, MO
New York University College of Dentistry, New York, NY
Northeast Ohio Medical University Bitonte School of Dentistry, Rootstown, OH
Nova Southeastern University College of Dental Medicine, Fort Lauderdale, FL
Ohio State University College of Dentistry, Columbus, OH
Oregon Health & Science University School of Dentistry, Portland, OR
Pacific Northwest University School of Dental Medicine, Yakima, WA
Ponce Health Sciences University, Ponce, PR
Roseman University of Health Sciences College of Dental Medicine, South Jordan, UT
Rutgers School of Dental Medicine, Newark, NJ
Schulich School of Medicine & Dentistry (Western University), London, ON
Southern Illinois University School of Dental Medicine, Alton, IL
Stony Brook University School of Dental Medicine, Stony Brook, NY
Temple University Kornberg School of Dentistry, Philadelphia, PA
Texas A&M University College of Dentistry, Dallas, TX
Texas Tech University Health Sciences Center El Paso Woody L. Hunt School of Dental Medicine, El Paso, TX
The Dental College of Georgia at Augusta University, Augusta, GA
Touro College of Dental Medicine at New York Medical College, Hawthorne, NY
Tufts University School of Dental Medicine, Boston, MA
Universidad Ana G. Méndez, Gurabo, PR
Université de Montréal Faculté de médecine dentaire, Montréal, QC
Université Laval Faculté de médecine dentaire, Québec, QC
University at Buffalo School of Dental Medicine, Buffalo, NY
University of Alabama School of Dentistry, Birmingham, AL
University of Alberta School of Dentistry, Edmonton, AB
University of British Columbia Faculty of Dentistry, Vancouver, BC
University of California Los Angeles School of Dentistry, Los Angeles, CA
University of California San Francisco School of Dentistry, San Francisco, CA
University of Colorado School of Dental Medicine, Aurora, CO
University of Connecticut School of Dental Medicine, Farmington, CT
University of Detroit Mercy School of Dentistry, Detroit, MI
University of Florida College of Dentistry, Gainesville, FL
University of Illinois Chicago College of Dentistry, Chicago, IL
University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA
University of Kentucky College of Dentistry, Lexington, KY
University of Louisville School of Dentistry, Louisville, KY
University of Manitoba Faculty of Dentistry, Winnipeg, MB
University of Maryland School of Dentistry, Baltimore, MD
University of Michigan School of Dentistry, Ann Arbor, MI
University of Minnesota School of Dentistry, Minneapolis, MN
University of Mississippi Medical Center School of Dentistry, Jackson, MS
University of Missouri-Kansas City School of Dentistry, Kansas City, MO
University of Nebraska Medical Center College of Dentistry, Lincoln, NE
University of Nevada Las Vegas School of Dental Medicine, Las Vegas, NV
University of New England College of Dental Medicine, Portland, ME
University of North Carolina Chapel Hill School of Dentistry, Chapel Hill, NC
University of Oklahoma College of Dentistry, Oklahoma City, OK
University of Pennsylvania School of Dental Medicine, Philadelphia, PA
University of Pittsburgh School of Dental Medicine, Pittsburgh, PA
University of Puerto Rico School of Dental Medicine, San Juan, PR
University of Saskatchewan College of Dentistry, Saskatoon, SK
University of Tennessee Health Science Center College of Dentistry, Memphis, TN
University of Texas Health Science Center at Houston School of Dentistry, Houston, TX
University of Texas Health Science Center at San Antonio School of Dentistry, San Antonio, TX
University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, CA
University of Toronto Faculty of Dentistry, Toronto, ON
University of Utah School of Dentistry, Salt Lake City, UT
University of Washington School of Dentistry, Seattle, WA
Virginia Commonwealth University School of Dentistry, Richmond, VA
West Virginia University School of Dentistry, Morgantown, WV
Western University of Health Sciences College of Dental Medicine, Pomona, CA
Other
Enter Name of Dental School
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Projected Graduation Year
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Enter AGD Number
If applicable.
How did you hear about DSSN?
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Internet search
Podcast
Speaker
Student referral
Social media
Other
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Enter Name of Speaker
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Referring Student
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Please Specify
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DSSN Ambassador Honor Code
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By submitting this application, I acknowledge that I have read and agree to abide by the
DSSN Ambassador Honor Code
and understand that failure to uphold these standards may result in removal from the program.
I agree
