Maryland State Board of Dental Examiners

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DHMH Home

Home | Forms & Applications

Forms & Applications

Initial Applications

Reactivation/Reinstatement

Renewal

Application for Recognition as a Specialist

Complaint

Miscellaneous Forms

Initial Applications [top of page]
Dentist (by NERB examination)	Adobe .pdf format	MS Word .doc format
Dentist (by waiver of clinical examination)	Adobe .pdf format	MS Word .doc format
Dentist - Limited Dental - Graduate of U.S. or Canadian Dental School	Adobe .pdf format	MS Word .doc format
Dentist - Limited Dental - Graduate of Foreign Dental School	Adobe .pdf format	MS Word .doc format
Dentist - Teacher	Adobe .pdf format	MS Word .doc format
Dentist - Dental Pediatric Fellow	Adobe .pdf format	MS Word .doc format
Dental Hygienist (by NERB examination)	Adobe .pdf format	MS Word .doc format
Dental Hygienist (by waiver of clinical examination)	Adobe .pdf format	MS Word .doc format
Dental Hygienist - Teacher	Adobe .pdf format	MS Word .doc format
Dentist and Dental Auxiliary Personnel Volunteer application	Adobe .pdf format	MS Word .doc format
General Anesthesia & Parenteral Sedation Evaluators	Adobe .pdf format	MS Word .doc format
Application for Initial Anesthesia and Sedation Permits and Certificates	Adobe .pdf format	MS Word .doc format
Instructions for Anesthesia and Sedation Application	Adobe .pdf format	MS Word .doc format
Reactivation/Reinstatement [top of page]
Reactivation (Dentist or Dental Hygienist)	Adobe .pdf format	MS Word .doc format
Reactivation Guidelines (Dentist or Dental Hygienist)	Adobe .pdf format	MS Word .doc format
Reinstatement (Dentist or Dental Hygienist)	Adobe .pdf format	MS Word .doc format
Reinstatement Application (Dental Radiation Technologist)	Adobe .pdf format	MS Word .doc format
Reinstatement Guidelines (Dental Radiation Technologist)	Adobe .pdf format	MS Word .doc format
Renewal [top of page]
Dentist	Adobe .pdf format	MS Word .doc format
Dental Hygienist	Adobe .pdf format	MS Word .doc format
Permits (General Anesthesia Admin/Facility & Parenteral Sedation Admin./Facility )	Adobe .pdf format	MS Word .doc format
Dental Radiation Technologist	The renewal period for Dental Radiation Technologists has ended
Application for Recognition as a Specialist [top of page]
Application for Recognition as a Specialist	Adobe .pdf format	MS Word .doc format
Complaint [top of page]
Complaint Form	Adobe .pdf format	MS Word .doc format
Miscellaneous Forms [top of page]
Change of Information (name, address, etc.)	Adobe .pdf format	MS Word .doc format
Application for Corporate Name	Adobe .pdf format	MS Word .doc format

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