Organization Information

Please indicate what type of organization is applying: Federally Qualified Health Center, School, Primary Care Clinic, Church, Public or Government Entity, 501(c)(3) nonprofit organization, Tribal Organization, Health Department, or Other
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If tax exempt, please make sure to upload your U.S. Treasury (IRS) tax determination letter proving your organization’s non-profit status. If you do not upload it now, you’ll have two days to email a current copy to corpcomm@deltadentalks.com or fax it to 316-462-3341.

Contact Information

Used to communicate with you about your Smile Kit application
Used to communicate with you about your Smile Kit application

Project/Program Information

Estimated number of direct lives affected annually

Smile Kit Request

Smile kits are available in two sizes: Adult Kits contain toothbrushes sized for ages 8 and up, and Child, contain toothbrushes sized for ages 4-7. PLEASE NOTE: DDKS ships Smile Kits in increments of 50 per size. The minimum number of kits you can request is 50 Smile Kits per size. Please double check that your requested number of kits is in increments of 50 (for example: if you need 245 Adult Kits, please request 250 kits).

Questions on Our

Community Benefit Initiatives?

Contact Delta Dental of Kansas’ Community Benefit department.