- Home
- Find a PACE Provider
- PACE Approved Providers
- Apply for PACE Approval
- Constituent Approval Representatives
Applications for local provider approval should be mailed to the program provider approval representative for the state or province in which you provide continuing education.
United States
Alabama
Gary L. Myers DMD, MAGD
531 Creekview Circle
B’Ham, AL 35226
gmyers7472@gmail.com
Cell 205-999-1781
Alaska
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Arizona
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Arkansas
Dr. R. Lee Hinson
5304 Mabelvale Pike
Little Rock, AR 72209
501.565.0949
5304 Mabelvale Pike
Little Rock, AR 72209
501.565.0949
California
Terri Iwamoto-Wong, BS, MBA
Executive Director
California Academy of General Dentistry
877.408.0738
Email completed applications to terri@cagd.com
All application materials must be contained within a single PDF file.
Fee: $300, contact for credit card invoice or make check payable to the California AGD and send to:
PO BOX 22417
Sacramento, CA 95822
Executive Director
California Academy of General Dentistry
877.408.0738
Email completed applications to terri@cagd.com
All application materials must be contained within a single PDF file.
Fee: $300, contact for credit card invoice or make check payable to the California AGD and send to:
PO BOX 22417
Sacramento, CA 95822
Colorado
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Connecticut
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Delaware
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
District of Columbia
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Florida
Patricia Jenkins
Executive Director
5721 NW 84th Terr
Gainesville, FL 32653
352-663-3763
Email applications to flagdinfo@gmail.com
Fee: FL-AGD staff will contact you for payment once the review has been completed. The fee will be determined by the number of years of approval awarded. If you have questions regarding the application fee structure before applying please contact FL-AGD . One-year: $150, Two years: $225, Three years: $300 Four years: $350
Georgia
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Hawaii
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Idaho
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Illinois
Ms. Jana West, Constituent Executive
217-617-3337
Email completed applications to agd4illinois@gmail.com
Fee: $300, pay electronically after submission of the application via this link https://ilagd.org/event/pace-application/
217-617-3337
Email completed applications to agd4illinois@gmail.com
Fee: $300, pay electronically after submission of the application via this link https://ilagd.org/event/pace-application/
Indiana
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Iowa
Dr. Craig Driver
1965 Crabapple Lane
Waterloo, IA 50701
319.830.6790
Fee: $35/1 year or $55/3 years (Make check payable to the Iowa AGD)
1965 Crabapple Lane
Waterloo, IA 50701
319.830.6790
Fee: $35/1 year or $55/3 years (Make check payable to the Iowa AGD)
Kansas
Dr. Mark Armfield
2814 Ohio St
Augusta, KS 67010-2361
316.775.5451
Fee: $200 (Make check payable to Kansas AGD)
2814 Ohio St
Augusta, KS 67010-2361
316.775.5451
Fee: $200 (Make check payable to Kansas AGD)
Kentucky
Dr. M. Samantha Shaver 7926 Preston Way
Louisville, KY 40219-3848
502.968.1412
Louisville, KY 40219-3848
502.968.1412
Louisiana
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Maine
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Maryland
Dr. Charles A. Young
15 Malibu Ct.
Baltimore, MD 21204
410.583.7940
cyoung3@comcast.net
Fee: $250 electronic or paper submission (Make check payable to the Maryland AGD)
15 Malibu Ct.
Baltimore, MD 21204
410.583.7940
cyoung3@comcast.net
Fee: $250 electronic or paper submission (Make check payable to the Maryland AGD)
Massachusetts
Jane F. Martone, DDS, MAGD
75 Court St.
Westfield, MA 01085-3504
413.568.1062
Fax: 413.572.6961
Fee: $300 (Make check payable to the Massachusetts AGD)
75 Court St.
Westfield, MA 01085-3504
413.568.1062
Fax: 413.572.6961
Fee: $300 (Make check payable to the Massachusetts AGD)
Michigan
Dr. Amanda Yousif, DDS, FAGD
4224 East 10 Mile Road
Warren, MI 48091
586.756.6351
Fax: 586.756.6253
amandayousif@gmail.com
Fee: $295 (Make check payable to the Michigan AGD)
4224 East 10 Mile Road
Warren, MI 48091
586.756.6351
Fax: 586.756.6253
amandayousif@gmail.com
Fee: $295 (Make check payable to the Michigan AGD)
Minnesota
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Mississippi
Dr. Shannon P. Patterson
615 Hwy S1 South
Brookhaven, MS 39601
601.833.0746
Fee: $25 (Make check payable to the Mississippi AGD)
615 Hwy S1 South
Brookhaven, MS 39601
601.833.0746
Fee: $25 (Make check payable to the Mississippi AGD)
Missouri
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Montana
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Nebraska
Dr. Wesley N. Parks
4210 Pioneer Woods Dr. Ste D
Parks Family Dental
Lincoln, NE 68506
(402) 484-6042
Email applications to info@nebraskaagd.org
4210 Pioneer Woods Dr. Ste D
Parks Family Dental
Lincoln, NE 68506
(402) 484-6042
Email applications to info@nebraskaagd.org
Nevada
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
New Hampshire
Michael J. Melkers, DDS, MAGD
71 Lyme Road
Hanover, NH 03755
Office: 603-643-3104
Mobile: 509-868-7790
Fee: $200 (Make check payable to the New Hampshire AGD)
New Jersey
Kosmas Kasimatis, DMD
900 Easton Ave Ste 31
Somerset, NJ 08873-1760
(908) 510-3080
Fee: $200 (Make check payable to New Jersey AGD)
New Mexico
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
New York
Paula Bostick
Executive Director
1902 Whitestone Expy
Ste 204
Whitestone, NY 11357-3099
718.747.3353
Email questions only to paulaj@nysagd.org
Fee: $250 for non-AGD member program facilitators, $150 for AGD member program facilitators (Make check payable to New York State Academy of General Dentistry) *$50 annual administrative fee is applicable to all providers during their approval term.
Executive Director
1902 Whitestone Expy
Ste 204
Whitestone, NY 11357-3099
718.747.3353
Email questions only to paulaj@nysagd.org
Fee: $250 for non-AGD member program facilitators, $150 for AGD member program facilitators (Make check payable to New York State Academy of General Dentistry) *$50 annual administrative fee is applicable to all providers during their approval term.
North Carolina
NC AGD Executive Office
ncagd.org
Attn: Patricia Jenkins
Email completed applications to ncagdexecutive@gmail.com
Fee: NC-AGD will contact you for payment once the review has been completed. If you have questions regarding the application fee structure before applying please contact NC-AGD.
North Dakota
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Ohio
James H. Cottle DDS
8245 West Shore Dr.
Westerville, OH 43082
cottle.1@osu.edu
Fee: $100 (Make check payable to the Ohio AGD)
8245 West Shore Dr.
Westerville, OH 43082
cottle.1@osu.edu
Fee: $100 (Make check payable to the Ohio AGD)
Oklahoma
Erin Sexson, DDS
1113 Huntington Ave.
Oklahoma City, OK 73116
(405) 650-3755
1113 Huntington Ave.
Oklahoma City, OK 73116
(405) 650-3755
Oregon
Dr. Kimberly Wright DMD, MAGD
Mail completed application with payment to:
Oregon Academy of General Dentistry
13333 SW 68th Parkway, #010
Tigard, OR 97223
Email questions to: staff@oragd.org
Fee: $200 (make check payable to Oregon AGD)
Mail completed application with payment to:
Oregon Academy of General Dentistry
13333 SW 68th Parkway, #010
Tigard, OR 97223
Email questions to: staff@oragd.org
Fee: $200 (make check payable to Oregon AGD)
Pennsylvania
Steve Neidlinger, CAE
Executive Director
Pennsylvania Academy of General Dentistry
4076 Market St, Ste 209
Camp Hill, PA 17011
steve@pennagd.org
ph: 717-737-4682
Fee: PAGD staff will contact you for payment once the review has been completed. If you have questions regarding the application fee structure before applying please contact PAGD.
Executive Director
Pennsylvania Academy of General Dentistry
4076 Market St, Ste 209
Camp Hill, PA 17011
steve@pennagd.org
ph: 717-737-4682
Fee: PAGD staff will contact you for payment once the review has been completed. If you have questions regarding the application fee structure before applying please contact PAGD.
Puerto Rico
Aldo L. Miranda-Collazo, DMD
Constituent President
249 Calle Las MariasHyde ParkSan Juan, PR
00927-4224
787.751.5090
Fax: 787.751.5090
Email: gala@coqui.net
Constituent President
249 Calle Las MariasHyde ParkSan Juan, PR
00927-4224
787.751.5090
Fax: 787.751.5090
Email: gala@coqui.net
Rhode Island
Sarah Eager, DDS, FAGD
600 Wampanoag Trail Suite A
Riverside, RI 02915
(401) 434-2626
Email: rhodeislandagd@gmail.com
Fee: $250 (Make check payable to the Rhode Island AGD)
600 Wampanoag Trail Suite A
Riverside, RI 02915
(401) 434-2626
Email: rhodeislandagd@gmail.com
Fee: $250 (Make check payable to the Rhode Island AGD)
South Carolina
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
South Dakota
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Tennessee
Anthony Martin, DMD
161 Capital Dr. Suite 101
Knoxville, TN 37922
865-384-4888
amartin@knoxvilledental.com
Fee: $300 (Make check payable to the Tennessee AGD)
Texas
Texas AGD
PACE Division
1016 La Posada Drive
Suite 210
Austin, TX 78752
512.371.7144
education@tagd.org
Fee: $182 One year approval – first time applicants only / $423 Up to four years approval – renewing applicants only (Make check payable to the Texas AGD)
Utah
Attn: David S. Peterson DDS, FAGD
The Dental Studio
7410 S. Creek Rd, STE 303
Sandy, UT 84093
dsherwinp@gmail.com
307-254-4359 cell
801-278-4787 office
Fee: $200 (Make check payable to Utah AGD)
The Dental Studio
7410 S. Creek Rd, STE 303
Sandy, UT 84093
dsherwinp@gmail.com
307-254-4359 cell
801-278-4787 office
Fee: $200 (Make check payable to Utah AGD)
Vermont
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Virgin Islands
Dr. Raymond Para
720 Yorklyn Road Ste. 120
Hockessin, DE 19707
302.234.2728
720 Yorklyn Road Ste. 120
Hockessin, DE 19707
302.234.2728
Virginia
Cynthia M. Southern, DDS
62 E. Main St.
Pulaski, VA 24301
P: 540.980.5129
F: 540.980.5179
Fee: $200
(Make check payable to the Virginia AGD)
62 E. Main St.
Pulaski, VA 24301
P: 540.980.5129
F: 540.980.5179
Fee: $200
(Make check payable to the Virginia AGD)
Washington
Washington AGD
PACE Division
19415 International Blvd, #410
SeaTac, WA 98188
Office: 206-212-4969
Email: info@washingtonagd.org
Fee: Member (Active, Affiliate or Associate): $295
Nonmembers: $695 (Make check payable to Washington AGD)
PACE Division
19415 International Blvd, #410
SeaTac, WA 98188
Office: 206-212-4969
Email: info@washingtonagd.org
Fee: Member (Active, Affiliate or Associate): $295
Nonmembers: $695 (Make check payable to Washington AGD)
West Virginia
Dr. Bruce Cassis
P.O. Box 926
Fayetteville, WV 25840
(304) 574-0424
P.O. Box 926
Fayetteville, WV 25840
(304) 574-0424
Wisconsin
Jerome M. Teclaw DDS SC
9401 West Beloit Road
Suite 110
Milwaukee, WI 53227
Fee: $90 (Make check payable to Wisconsin AGD)
9401 West Beloit Road
Suite 110
Milwaukee, WI 53227
Fee: $90 (Make check payable to Wisconsin AGD)
Wyoming
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
Canada
Alberta
Kulwant Turna, DDS
110 Pertosa Drive Unit 1
Brampton, ON
L6X 5E9 CANADA
905.456.2726
turnak@yahoo.com
Fee:
1 Year/$250 Canadian
3 Year/$600 Canadian
(Make check payable to Ontario AGD)
110 Pertosa Drive Unit 1
Brampton, ON
L6X 5E9 CANADA
905.456.2726
turnak@yahoo.com
Fee:
1 Year/$250 Canadian
3 Year/$600 Canadian
(Make check payable to Ontario AGD)
Atlantic Provinces
Dr. Michael J. Taylor
57 Carlton Street
St. John, NB
E2L 2Z2 CANADA
506.634.8455
57 Carlton Street
St. John, NB
E2L 2Z2 CANADA
506.634.8455
British Columbia
Kulwant Turna, DDS
110 Pertosa Drive
Unit 1
Brampton, ON
L6X 5E9 CANADA
905.456.2726
turnak@yahoo.com
Fee:
1 Year/$250 Canadian
3 Year/$600 Canadian
(Make check payable to Ontario AGD)
110 Pertosa Drive
Unit 1
Brampton, ON
L6X 5E9 CANADA
905.456.2726
turnak@yahoo.com
Fee:
1 Year/$250 Canadian
3 Year/$600 Canadian
(Make check payable to Ontario AGD)
Manitoba
Kulwant Turna, DDS
110 Pertosa Drive
Unit 1
Brampton, ON
L6X 5E9 CANADA
905.456.2726
turnak@yahoo.com
Fee:
1 Year/$250 Canadian
3 Year/$600 Canadian
(Make check payable to Ontario AGD)
110 Pertosa Drive
Unit 1
Brampton, ON
L6X 5E9 CANADA
905.456.2726
turnak@yahoo.com
Fee:
1 Year/$250 Canadian
3 Year/$600 Canadian
(Make check payable to Ontario AGD)
Northwest Territories
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $200 (Contact AGD PACE staff for payment instructions)
Effective April 1, 2024, the fee will increase to $250
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $200 (Contact AGD PACE staff for payment instructions)
Effective April 1, 2024, the fee will increase to $250
Effective Jan. 1 2027, the fee will increase to $290
Ontario
Kulwant Turna, DDS
110 Pertosa Drive Unit 1
Brampton, ON
L6X 5E9 CANADA
(905) 456-2726
turnak@yahoo.com
Fee:
1 Year/$250 Canadian
3 Year/$600 Canadian
(Make check payable to Ontario AGD)
110 Pertosa Drive Unit 1
Brampton, ON
L6X 5E9 CANADA
(905) 456-2726
turnak@yahoo.com
Fee:
1 Year/$250 Canadian
3 Year/$600 Canadian
(Make check payable to Ontario AGD)
Quebec
Dr. Leonardo Nassani
1409 Rue Islemere
Laval, QC
H7Y 1M7 CANADA
nassani.leonardo@gmail.com
614-216-1616
Fee: $100 Canadian (Make check payable to Quebec AGD)
1409 Rue Islemere
Laval, QC
H7Y 1M7 CANADA
nassani.leonardo@gmail.com
614-216-1616
Fee: $100 Canadian (Make check payable to Quebec AGD)
Saskatchewan
Email completed applications to pace@agd.org
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290
All application materials must be contained within a single PDF file.
AGD PACE staff will confirm receipt of the application within two business days.
If you do not receive a confirmation, please contact the AGD at
888.243.3368 ext. 4114 to ensure your application was received.
Fee: $250 (Contact AGD PACE staff for payment instructions)
Effective Jan. 1 2027, the fee will increase to $290