Sam Tanoglu, D.M.D

General & Cosmetic Dentistry

101 Pleasant Street- Suite 208

Phone: (508) 770-0808 | Fax: (508) 754-3145

drsam@smilesbytanoglu.com

VIP Club

Dr. Sam Tanoglu would like to welcome you to our VIP Club. This club was created for people

without dental insurance and for patients who do not have enough benefits with their

insurance company. Being a member is easy and the benefits are tremendous.

As a member you will receive 20% OFF of all services (excluding crowns, veneers, implants and

dentures- they are 15% OFF) for the entire family.

To be a member in this club there is an annual fee of (*fees can be renewed yearly)

• Individual - $75

• Couple - $135

• Family (Unlimited members) - $175

Please note if you have insurance benefits, this VIP plan would apply after your insurance has

reached its max.

Keep in mind 15% OFF for veneers, crowns, implants, and dentures

Member Name:__________________________________________________________

Date of Membership:______________________________________________________

Member Signature:________________________________________________________