Delta Dental Of Nebraska - Brokers

Current Location: Delta Dental Of Nebraska > Brokers > Join Us

If you are a broker licensed with the Department of Commerce, and you would like to represent Delta Dental, please contact Delta Dental of Nebraska at 402-397-4878 or toll-free at 800-736-0710 to obtain the following forms:

Broker Commission Agreement
Taxpayer Identification Number Request (or IRS form W-9)
Copy of individual and/or agency license

When you have completed the above forms, send them along with a copy of your current license to:

Delta Dental of Nebraska
11235 Davenport St., Suite 105
Omaha, NE 68154