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9750 Miramar Road
Suite #220
San Diego, CA 92126
Email: dental@feasc.com
Fax: 858-564-0423

Toll Free 888-647-8777

Learn more about your Federal Benefits

Dental and Vision Enrollment Form

Please fill out the following form to sign up for a American Payroll Insurance Services Dental and/or Vision plan.



*All information is confidential, your SS# is used in conjunction with your payroll deduction
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Dependent Information
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