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TPL Application

DSN is a community where dentists learn to grow their business, get CE, and save on dental products, equipment, and services that they buy everyday.

Learn More About DSN

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Name*
First Last
Are you currently subscribed to DSN?*
Preferred DSN Email Address*
(Your Future Login)*
Cell Phone Number*

Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Clinic Name*
Simply part of the vetting process (even if not an owner, we want to learn about where you work)
How many clinics are you an owner in, if any?*
If an Associate, enter 0.
Please enter a number from 0 to 99.
Dental License Number*
AGD Number
Are you a member of the AGD? If so, please provide AGD number for online CE submission.
Annual Revenue*

DSN provides our partners with a list of our members and contact information so you don’t miss a beat in savings with suppliers you may already be using!*
We understand and value our member's privacy. If sharing your office information with our partners is something you would like to opt-out of, we get it! Simply click "Do not share my information".
- Yes, share my information with DSN vendors
- No, do not share my information with DSN vendors
What part of the dental success network are you most interested?*
- Select All
- Workplace Community
- Vendor Discounts
- Continuing Education
- Team Training
Shirt Size*
- Extra Small
- Small
- Medium
- Large
- Extra Large

DSN Membership
Click here to view the DSN terms and conditions.
Untitled*
- I agree to the DSN terms and conditions.
Cancellation/Refund Policy*
CANCELLATION POLICY: Members can cancel at ANYTIME. All cancellation requests must be submitted through the “Contact Us” form located anywhere on the site. All cancellation requests submitted 24 hours prior to invoice due date will be charged. However, Dental Success Network will refund the total invoice amount. Any cancellation request submitted over the weekend will be reviewed and processed the next business day. For questions regarding DSN’s cancellation policy please contact
[email protected]
REFUND POLICY: All refunds are processed at DSN discretion excluding members who request to cancel membership within 24 hours of invoice due date. Members who have requested to cancel their membership within 24 hours of the invoice due date can expect a full refund. Refunds will not be processed to non-usage of the network.
For questions regarding DSN’s cancellation policy please contact [email protected]
I agree to the Cancellation & Refund policy.
If you were referred to DSN by an existing member, enter their first and last name here:

Finally, you understand that, if accepted, there is a monthly membership fee of $199 per month once your complementary year expires*
After one (1) complementary year of DSN you will be charged $199 per month. Your complimentary year of DSN is contingent upon an active subscription to TPL (The Practice Launchpad). This is a NO CONTRACT, CANCEL ANYTIME approach because we want you in Position #1...finally. Why pay? Communities that pay, pay attention. This ensure we have a high-quality group of Members and that we can pay our EXPERTS and the most influential people in dentistry paid to pay attention to YOU!
- Yes
Credit Card*
Configuration Required: To use the Stripe field, please configure your Stripe Settings.
What part of the Dental Success Network are you most interested in?*
- Savings & Vendor Discounts
- Team Training
- Continued Education
- Startup & Acquisition
- Growing My Practice
What three challenges can we help you solve?*
*Please Select Three
- Systemization Implementation
- Team Culture
- Become a Better Leader
- Understanding Cash Flow
- Inventory & Overhead Control
- Understanding My Business

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CALL

(928) 968-3505

EMAIL

[email protected]

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Terms & Conditions