Mobile Dental Unit & Portable Dental Unit Permit

Other Applications

A Mobile Dental Unit & Portable Dental Permit is required if you operate a facility in which your dentistry is being practiced in a mobile facility that is routinely towed, moved or transported from one location or another, OR if you practice dentistry in a non-facility in which dental equipment being used is transported on a temporary basis at an out-of-office location.

A person who holds this type of permit is someone who is authorized to offer dental services in Arizona or a nonprofit organization, school district or school or institution of higher education. 

Online submission (Once all required fields are completed, a "Click to Sign" button will display at the bottom of your screen.)

Name Change Form


Pursuant to A.R.S. § 32-1262(H), if you legally change your name and wish that the renewed license, or immediately requested license, be in the new name, please complete this name change form.

NAME CHANGE FORM - online Submission (Once all required fields are completed, a "Click to Sign" button will display at the bottom of your screen.)

Problems With a Dentist, Dental Hygienist or Denturist


Anyone alleging to have been "harmed" by an Arizona dentist, hygienist or denturist may file a complaint against that professional. In order to file a complaint, please complete the online form below and use the second page, of the complaint form, to describe in detail what you are aggrieving. If you were treated by another licensee before or after the treatment you are now complaining, please provide the contact information for each licensee. If the list of licensees is more than two, please use the link, on the complaint form, to attach a comprehensive list. Lastly, please place the links on the complaint form, to provide other documents you wish for the Board to consider. 

If the Dental Board finds that a licensee violated its statutes and/or rules, restitution may be ordered. Restitution is any fee the patient paid out-of-pocket and does not include fees paid on your behalf by an insurance company. If you are seeking damages beyond your out-of-pocket expenses, you must seek an award from a civil/criminal court.

COMPLAINT FORM - Online submission

Other Options:

  • If you have not spoken to the licensee regarding the basis of the complaint, you are encouraged to do so. Licensees are, in most cases, business people and are sensitive to complaints about their services. You may feel reluctant to approach the licensee or his/her supervisor about your dissatisfaction, but many complaints are resolved in the manner and if might be your most convenient way to proceed. If you feel too intimidated or have failed with this approach, a written request for a resolution from you to the licensee is  another suggestion.
  • If the dentist is a member of the Arizona State Dental Association ("AzDA"), you may wish to contact them for help. For more information on how the AzDA may be helpful, please contact them at 480.344.5777 or visit their website at
  • Seek legal counsel for civil and or criminal action.