Golden West Dental - Provider Area - Eligibility Listing



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Provider Area

Eligibility Listing

SELECT ProvNo FROM ProviderAddress WHERE ProvNo='#form.Logon__ID#' AND Password='#form.Logon__PassWord#' SELECT * FROM ProviderAddress WHERE ProvNo = '#SysGdwId#'
#GetProviderData.PracticeName#
Please provide one or more of the following pieces of information:
Member No
Member Last Name
Member First Name
City
Birth Date