North Carolina State Board of Dental

ensuring dental profession merit

.........................................................................................................................

Forms

**Please note that once your application is received by the Board office,
the process takes at least 90 days.**

• Applications may be downloaded from this site using Adobe Acrobat Reader.
The Acrobat Reader can be downloaded from this site. Here's How to do this!

DENTAL PROVISIONAL, LICENSE & LICENSURE BY CREDENTIALS APPLICATIONS

Download the Dental/Provisional License application now
(This application is for those individuals who took or will take the CITA exam)

Download the Dental Licensure by Credentials application now

HYGIENE PROVISIONAL, LICENSURE EXAMINATION & LICENSURE BY CREDENTIALS APPLICATIONS

Download the Hygiene/Provisional Licensure Application NOW
(This application is for those individuals who took or will take the CITA exam)

Download the Dental Hygiene Licensure by Credentials application now

DENTAL INTERN APPLICATIONS

Download Application for Intern Permit

Download Application for Renewal of Intern Permit
(This application is for those individuals who currently
have an intern permit in North Carolina.)

DENTAL INSTRUCTOR'S APPLICATION

Download an Instructor's Application NOW

DENTAL LIMITED VOLUNTEER APPLICATION

Download a Limited Volunteer Application NOW

Download a Temporary Volunteer Application NOW

ANESTHESIA & SEDATION PERMITS

Download the Anesthesia Permit application now

Download the Moderate Pediatric Conscious Sedation Permit application now

Download the Moderate Conscious Sedation Permit application now

Download the Limited Moderate Conscious Sedation Permit application now

Download the Minimal Conscious Sedation Permit application now

REINSTATEMENT APPLICATIONS

Download Application for Reinstatement (DDS)

Download Application for Reinstatement (DH)

Download Application for Reinstatement (General Anesthesia)