- Home
- 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
Stephen Stricklin, DMD, MAGD
3748 Shady Cove Drive
Vestavia Hills, Alabama 35243
(205) 907-9050
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)
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)
5304 Mabelvale Pike
Little Rock, AR 72209
501.565.0949
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: $225, contact for credit card invoice or make check payable to the California AGD and send to:
PO BOX 22417
Sacramento, CA 95822
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)
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)
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)
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)
Patricia Jenkins
Executive Director
5721 NW 84th Terr
Gainesville, FL 32653
866.620.0773
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
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)
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)
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)
701 Main St.
Augusta, IL 62311
217-617-3337
Email completed applications to agd4illinois@gmail.com
Fee: $250 (make check payable to Illinois AGD)
1503 Ohio Street
Terre Haute, IN
47807-4009
812.232.4252
Fax: 812.238.9143
Fee: $25 (Make check payable to the Indiana 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)
2814 Ohio St
Augusta, KS 67010-2361
316.775.5451
Fee: $200 (Make check payable to Kansas AGD)
Louisville, KY 40219-3848
502.968.1412
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)
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)
15 Malibu Ct.
Baltimore, MD 21204
410.583.7940
cyoung3@comcast.net
Fee: $200 electronic or paper submission (Make check payable to the Maryland AGD)
75 Court St.
Westfield, MA 01085-3504
413.568.1062
Fax: 413.572.6961
Fee: $250 (Make check payable to the Massachusetts 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)
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)
615 Hwy S1 South
Brookhaven, MS 39601
601.833.0746
Fee: $25 (Make check payable to the Mississippi AGD)
Dr. Benjamin T. Gallion, DDS
1402 South Elliott Ave
Aurora, MO 65605
drbengalliondds@gmail.com
Fee: $200 (Make check payable to the Missouri AGD)
Family Dental Group Southgate Mall
2901 Brooks St.
Missoula, MT 59801
11840 Nicholas St Ste 210
Omaha, NE 68154-4475
402.498.0400
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)
Kosmas Kasimatis, DMD
900 Easton Ave Ste 31
Somerset, NJ 08873-1760
(908) 510-3080
Fee: $200 (Make check payable to New Jersey AGD)
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)
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.
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.
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)
804 4th St E
South Point, OH 45680-9117
hal.jeter@jeterdds.com
Fee: $100 (Make check payable to the Ohio AGD)
1113 Huntington Ave.
Oklahoma City, OK 73116
(405) 650-3755
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)
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.
Constituent President
249 Calle Las MariasHyde ParkSan Juan, PR
00927-4224
787.751.5090
Fax: 787.751.5090
Email: gala@coqui.net
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)
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)
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)
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 AGD
PACE Division
1016 La Posada Drive
Suite 210
Austin, TX 78752
512.371.7144
coordinator@tagd.org
Fee: $175 One year approval – first time applicants only / $400 Up to four years approval – renewing applicants only (Make check payable to the Texas 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)
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)
720 Yorklyn Road Ste. 120
Hockessin, DE 19707
302.234.2728
62 E. Main St.
Pulaski, VA 24301
P: 540.980.5129
F: 540.980.5179
Fee: $200
(Make check payable to the Virginia 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)
P.O. Box 926
Fayetteville, WV 25840
(304) 574-0424
9401 West Beloit Road
Suite 110
Milwaukee, WI 53227
Fee: $90 (Make check payable to Wisconsin AGD)
Box 228
1702 Antelope
Kemmerer, WY 83101-0228
(307) 877-4715
Canada
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)
57 Carlton Street
St. John, NB
E2L 2Z2 CANADA
506.634.8455
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)
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)
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)
1409 Rue Islemere
Laval, QC
H7Y 1M7 CANADA
nassani.leonardo@gmail.com
614-216-1616
Fee: $100 Canadian (Make check payable to Quebec AGD)
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)