Dental Finance
Correct Choice Dental
199 N. El Camino Real E Encinitas CA 92024
(760) 203-6525

New Application

Complete the fields below to submit an application for financing with us.
Patient Information
Borrower Information
Must match U.S. Government Issued Photo ID.
Must match U.S. Government Issued Photo ID.
Must match U.S. Government Issued Photo ID.
Total gross monthly income before taxes. Alimony, Child Support or Separate Maintenance income need not be included unless relied upon for credit. You may include the amount you have available to spend from your assets. Stated income may be subject to income verification.
We recommend entering the borrower's email address as this is used for communications by our lenders. IMPORTANT: if you do not know the borrower's email address, please leave it blank.
Borrower Home Address (Must be Physical Address - No PO Boxes allowed)
Borrower Mailing Address