The Pennsylvania dental license application is the form you submit to the Pennsylvania State Board of Dentistry to get legal permission to practice dentistry in the state. Every person who wants to drill a tooth, write a prescription, or open a practice in Pennsylvania must file it first. You complete the form inside the online Pennsylvania Licensing System (PALS), and the Board reviews it against state law before it grants your license.
Getting this form wrong is not a small problem. A single mismatched name, a missing transcript, or a skipped background-check step can hold up your file for weeks or months, which can delay a job start date and cost you real income. Pennsylvania licenses tens of thousands of dental professionals, and the Board notes that the most common reason applications stall is incomplete documentation, not a failed exam. This guide walks you through the form field by field so your file moves through clean the first time.
Here is what you will learn:
- 🦷 What the Pennsylvania dental license application is and exactly who must file it
- 📋 Every document and ID number you must gather before you open PALS
- ✍️ A line-by-line walkthrough of each field, with sample entries you can copy
- 👥 Three full filled-out examples following real applicants from start to finish
- 💸 The current fees, filing steps, common mistakes, and answers to the questions filers ask most
What the Form Is and Who Must File It
The Pennsylvania dental license application is the official request for a license to practice dentistry, governed by the Dental Law at 63 P.S. § 120 and following. The form goes to the Pennsylvania State Board of Dentistry, which sits inside the Bureau of Professional and Occupational Affairs (BPOA) under the Department of State. The Board has the legal power to issue, deny, and discipline licenses, so the form is your formal entry into its system. You file it once to enter practice, then you renew the license every two years rather than re-applying.
Anyone who wants to practice dentistry in Pennsylvania must file this form before treating a single patient. That includes new dental school graduates, dentists moving in from another state, foreign-trained dentists, and faculty members at Pennsylvania dental schools. Practicing without a license is the unlicensed practice of a profession, which can bring fines and even criminal charges under state law. The form is the line between legal practice and a violation.
The application connects to several other moving parts. The Board checks your scores from the Joint Commission on National Dental Examinations, it confirms your clinical exam results, and it runs a criminal and child-abuse background check. The form is the hub that ties your education, your testing, and your character review into one file. Each piece must match, or the Board cannot approve you.
There are four main pathways, and you pick one when you start the form:
- Licensure by Examination for new and recent graduates
- Licensure by Endorsement (Criteria Approval) for dentists already licensed in another state
- Restricted Faculty License for full-time dental school faculty
- Temporary Volunteer License for retired or out-of-state dentists serving free in approved clinics
Before You Start: Documents and Information You Need
Open PALS only after you have every item below in hand, because the system lets you save and return, but a stalled file with missing pieces is the top reason applications sit unprocessed. Gather these first:
- Your full legal name as it appears on your Social Security card and exam reports. The Board cross-checks your name against your score reports, and a mismatch triggers a manual hold while staff confirm you are the same person.
- Your Social Security number. The state uses it for tax compliance and to run your background check; without it the form will not submit.
- Official dental school transcript showing your DDS or DMD degree. This proves you graduated from a CODA-accredited program, and a missing degree date stops the review cold.
- NBDE Parts I and II or INBDE score reports. These confirm you passed the national written exam, and the Board will not act on a file that lacks them.
- Clinical examination scores from ADEX, CDCA-WREB-CITA, CRDTS, or SRTA. Pennsylvania requires a clinical exam, so an empty clinical field means an automatic deficiency notice.
- Proof of current CPR certification. Clinical practice requires it, and an expired card forces you to re-upload before approval.
- Child abuse recognition training certificate (3 hours). This one-time training is required by law, and skipping it blocks the license from issuing.
- License verification from every other state where you hold or held a license. The Board needs to see you are in good standing, and an open complaint elsewhere can pause your file.
- A valid credit card or e-check for the application fee. PALS will not finish your submission without payment.
- Foreign-trained applicants: proof of a CODA-accredited advanced standing or supplemental program. Without it, a foreign dental degree alone does not qualify you.
If any single item is missing, the Board issues a deficiency letter and your clock effectively restarts when you reply, so front-load the gathering.
Where to Get the Form and How to Access It
There is no paper packet to mail for the standard dentist license anymore. The Pennsylvania State Board of Dentistry moved all dentist applications to the online PALS portal at pals.pa.gov, and the Board’s own Resources and Documents page confirms that applications, renewals, and updates are completed there. You will not find a downloadable Form X to print and sign for the main dentist license; the form lives inside your PALS account.
To reach it, go to pals.pa.gov and either sign in or create a free account using a personal email you will keep long term. After login, you select “Apply for New License,” choose Dentistry as the board, and choose Dentist as the license type. PALS then shows plain-language questions that branch based on your pathway, so the fields you see for examination differ from those for endorsement.
A few sub-applications still use a PDF. The Temporary Volunteer License – Dentist Only form is available as a PDF on the Board’s resources page, and it is mailed to the Board at P.O. Box 2649, Harrisburg, PA 17105-2649. For everything else, treat PALS as the only channel. Always confirm you are on a pa.gov address before entering your Social Security number, because look-alike sites do exist.
Step-by-Step: How to Fill Out the Pennsylvania Dental License Application Line by Line
The PALS dentist application is organized into logical sections. Below, each major field gets its own walkthrough. Numbers follow the order the fields appear on screen after you select the Dentist license type.
Section 1: Pathway / License Type Selection
What it asks in plain English. This field asks how you qualify: by examination, by endorsement (criteria approval), as restricted faculty, or as a temporary volunteer.
How to answer it. Click the radio button that matches your situation. New and recent graduates pick Licensure by Examination. Dentists with an active out-of-state license and five years of practice pick Licensure by Endorsement.
A specific example answer. Dr. Emily Carter, a 2026 graduate of Temple’s dental school, selects Licensure by Examination.
A nuance or edge case. If you graduated more than five years ago and have practiced steadily in another state, endorsement is usually faster than re-taking a clinical exam, so weigh that before clicking.
A common mistake on this field and its direct consequence. Picking the wrong pathway loads the wrong document checklist, and you may upload a full clinical-exam packet that the system then rejects as not required, costing you days.
A misconception people hold about this field. Many think you can switch pathways later with one click. You often must withdraw and restart, so choose the right path the first time.
Section 2: Full Legal Name
What it asks in plain English. This field asks for your complete legal name: first, middle, and last.
How to answer it. Type your name exactly as it appears on your Social Security card and your NBDE/INBDE score report. Include your middle name if your documents show it.
A specific example answer. Emily Rose Carter enters Carter as last name, Emily as first, and Rose as middle.
A nuance or edge case. If you recently married and your exam scores still show your maiden name, enter the maiden name in the legal-name field and use the Other Names Used field to list your married name, then upload your marriage certificate.
A common mistake on this field and its direct consequence. Entering a nickname like Em instead of Emily breaks the cross-check against your SSA and exam records, which triggers a manual identity hold.
A misconception people hold about this field. People think the name on the license can differ from the application. It cannot; the license prints exactly what you enter here.
Section 3: Social Security Number
What it asks in plain English. This field asks for your nine-digit Social Security number.
How to answer it. Type the number with no dashes if the field formats it for you, and double-check every digit before moving on.
A specific example answer. Emily enters 123-45-6789 in the SSN box.
A nuance or edge case. If you are a foreign-trained applicant without an SSN yet, the form may ask for an ITIN or direct you to contact the Board for guidance; do not invent a placeholder number.
A common mistake on this field and its direct consequence. One transposed digit links your file to the wrong tax and background records, which can flag you under the state’s tax-compliance check and freeze issuance.
A misconception people hold about this field. Some think the SSN is optional for privacy reasons. State law requires it for professional licensing, so the form will not submit without it.
Section 4: Date of Birth and Contact Information
What it asks in plain English. This section asks for your birth date, mailing address, phone number, and email.
How to answer it. Enter your date of birth in MM/DD/YYYY format. Provide a current mailing address and an email you check often, because the Board sends deficiency notices by email.
A specific example answer. Emily enters 07/14/2001, an address of 118 Maple Street, Philadelphia, PA 19103, and her personal Gmail.
A nuance or edge case. If you have a P.O. Box, you can use it for mail, but some screens ask for a physical address too, so have both ready.
A common mistake on this field and its direct consequence. Using a soon-to-expire school email means you miss the deficiency notice, and your file sits open while the deadline to respond runs.
A misconception people hold about this field. Filers assume the address must be in Pennsylvania. It does not have to be; out-of-state applicants list their current home address.
Section 5: Education / Dental School Information
What it asks in plain English. This section asks where you earned your dental degree and when you graduated.
How to answer it. Enter the full name of your CODA-accredited dental school, your degree (DDS or DMD), and your graduation date. Arrange for the school to send an official transcript to the Board.
A specific example answer. Emily enters Temple University Kornberg School of Dentistry, degree DMD, graduation 05/2026.
A nuance or edge case. Foreign-trained dentists enter their advanced standing program here, not their original foreign school, because the CODA-accredited program is what qualifies them.
A common mistake on this field and its direct consequence. Listing a graduation date the transcript has not yet confirmed creates a mismatch, and the Board holds the file until the official transcript arrives.
A misconception people hold about this field. People think self-reported education is enough. The Board only acts on the official transcript sent directly by the school.
Section 6: National Board Exam (NBDE / INBDE) Scores
What it asks in plain English. This field asks which national written exam you passed and your scores.
How to answer it. Indicate whether you passed NBDE Parts I and II or the INBDE, and arrange for the Joint Commission to release your scores to Pennsylvania.
A specific example answer. Emily selects INBDE and notes her pass date of 11/2025.
A nuance or edge case. Older applicants who took NBDE Parts I and II before the INBDE existed simply select that combination; both remain accepted.
A common mistake on this field and its direct consequence. Forgetting to release the scores from the testing agency means the Board sees an empty record and issues a deficiency, even though you passed.
A misconception people hold about this field. Filers think entering the score number is proof enough. The official electronic release from the exam agency is what the Board requires.
Section 7: Clinical Examination
What it asks in plain English. This field asks which Board-accepted clinical exam you passed.
How to answer it. Select your exam from ADEX, CDCA-WREB-CITA, CRDTS, or SRTA, and have the agency verify your result to the Board.
A specific example answer. Emily selects CDCA-WREB-CITA (ADEX) and her pass date of 03/2026.
A nuance or edge case. Endorsement applicants with five years of practice may not need a fresh clinical exam, so this field may not appear on their version of the form.
A common mistake on this field and its direct consequence. Choosing the wrong testing agency makes verification fail, because the Board requests confirmation from an agency that has no record of you.
A misconception people hold about this field. Many assume passing the national written exam covers the clinical requirement. They are separate, and Pennsylvania requires both.
Section 8: Pennsylvania Dental Law Examination
What it asks in plain English. This field asks you to confirm you passed the Pennsylvania Dental Law Examination.
How to answer it. Attest that you completed the open-book law exam, which covers the Dental Law and the Board’s regulations at 49 Pa. Code, and upload your certificate if prompted.
A specific example answer. Emily checks the attestation box and uploads her law-exam completion certificate dated 04/2026.
A nuance or edge case. Every pathway, including endorsement, faculty, and temporary volunteer, must pass this law exam, so do not skip it because you are licensed elsewhere.
A common mistake on this field and its direct consequence. Treating the law exam as optional leaves the attestation blank, and the Board cannot issue a license without it.
A misconception people hold about this field. People think the law exam is the same as the national board. It is a separate Pennsylvania-specific test on state rules.
Section 9: Criminal History and Disciplinary Disclosure
What it asks in plain English. This section asks whether you have any criminal convictions or past discipline against a professional license.
How to answer it. Answer each yes/no question honestly. If you answer yes, upload the court or board records and a brief written explanation.
A specific example answer. Emily answers No to all questions and moves on.
A nuance or edge case. A years-old DUI or an expunged matter may still need disclosure depending on the question wording; when in doubt, disclose and explain.
A common mistake on this field and its direct consequence. Hiding a conviction the background check later finds is treated as a false statement, which can mean denial far worse than the original offense.
A misconception people hold about this field. Filers think a minor or old offense automatically blocks licensure. The Board weighs context, and honest disclosure usually matters more than the offense itself.
Section 10: Child Abuse Recognition Training
What it asks in plain English. This field asks for proof of your one-time 3-hour child abuse recognition and reporting training.
How to answer it. Confirm completion and upload the certificate from a Department-approved training provider.
A specific example answer. Emily uploads her 3-hour child abuse recognition certificate dated 02/2026.
A nuance or edge case. This is a one-time requirement at initial licensure, but ongoing continuing education later includes related hours, so keep the certificate.
A common mistake on this field and its direct consequence. Uploading a generic CE certificate that does not meet the approved-provider rule causes a rejection and a deficiency notice.
A misconception people hold about this field. People think this is the same as the abuse-and-neglect CE for renewal. The initial 3-hour training is a distinct, one-time requirement.
Section 11: Out-of-State License Verification (Endorsement Filers)
What it asks in plain English. This field asks you to list every state where you hold or held a dental license.
How to answer it. List each state, license number, and status, then request official verification be sent to the Pennsylvania Board from each one.
A specific example answer. Dr. Raj Patel lists Ohio, License DEN.012345, Active and requests verification from the Ohio board.
A nuance or edge case. Endorsement requires graduation at least five years prior and five years of active practice, so be ready to document your practice history here.
A common mistake on this field and its direct consequence. Leaving off a state where you once held an inactive license looks like a concealment when the Board’s data sharing finds it, which delays approval.
A misconception people hold about this field. Filers think a clean record means verification is optional. The Board still requires official verification from each state.
Section 12: Attestation and Electronic Signature
What it asks in plain English. This final field asks you to swear that everything you entered is true and to sign electronically.
How to answer it. Read the statement, check the box, and type your full legal name as your electronic signature.
A specific example answer. Emily types Emily Rose Carter and dates it 05/2026.
A nuance or edge case. If a third party (like a credentialing service) helped you, you still must be the one to sign, because the attestation is personal.
A common mistake on this field and its direct consequence. Signing with initials or a different name than Section 2 creates a mismatch that can void the attestation and bounce the file.
A misconception people hold about this field. People think the electronic signature is informal. It carries the same legal weight as a sworn paper signature, including penalties for false statements.
Three Filled-Out Examples Using Real Scenarios
Below are three named applicants taken through the full form. Each table shows what they enter in the most important sections.
Example 1: Emily, a New Graduate Applying by Examination
| Form Section | What Emily Enters |
|---|---|
| Pathway / License Type | Licensure by Examination |
| Full Legal Name | Emily Rose Carter |
| Social Security Number | 123-45-6789 |
| Date of Birth | 07/14/2001 |
| Dental School | Temple University Kornberg School of Dentistry, DMD, 05/2026 |
| National Board Exam | INBDE, passed 11/2025 |
| Clinical Examination | CDCA-WREB-CITA (ADEX), 03/2026 |
| PA Dental Law Exam | Attested, certificate 04/2026 |
| Criminal History | No to all |
| Child Abuse Training | 3-hour certificate, 02/2026 |
| Signature | Emily Rose Carter, 05/2026 |
Example 2: Raj, an Out-of-State Dentist Applying by Endorsement
| Form Section | What Raj Enters |
|---|---|
| Pathway / License Type | Licensure by Endorsement (Criteria Approval) |
| Full Legal Name | Rajesh Anand Patel |
| Date of Birth | 03/22/1986 |
| Dental School | Ohio State University College of Dentistry, DDS, 05/2014 |
| National Board Exam | NBDE Parts I and II, passed 2013 |
| Out-of-State License | Ohio, DEN.012345, Active, in good standing |
| Years in Practice | 10 years active clinical practice |
| Continuing Education | 30 hours in the past two years |
| PA Dental Law Exam | Attested, certificate 05/2026 |
| Criminal History | No to all |
| Signature | Rajesh Anand Patel, 05/2026 |
Example 3: Mei, a Foreign-Trained Dentist Applying by Examination
| Form Section | What Mei Enters |
|---|---|
| Pathway / License Type | Licensure by Examination |
| Full Legal Name | Mei Lin Chen |
| Dental School (Qualifying) | University of Pennsylvania, Advanced Standing DMD, 05/2025 |
| Original Foreign Degree | Listed in Other Education, BDS, China, 2018 |
| National Board Exam | INBDE, passed 09/2024 |
| Clinical Examination | CRDTS, 02/2025 |
| PA Dental Law Exam | Attested, certificate 03/2025 |
| Social Security Number | Provided after issuance of SSN |
| Criminal History | No to all |
| Child Abuse Training | 3-hour certificate, 01/2025 |
| Signature | Mei Lin Chen, 04/2025 |
How to File the Completed Form
The standard dentist application is filed online, and the PALS portal is the only channel for it. After you finish all sections, the system prompts you to pay and submit in one flow. Keep your confirmation page, because it is your proof of filing.
-
Online (PALS). Submit at pals.pa.gov. The dentist application fee is $260, set by 49 Pa. Code § 33.3 and reflecting the increase effective July 1, 2025. PALS accepts credit card and electronic check. Processing typically runs a few weeks once your file is complete, and your proof of filing is the on-screen confirmation and the email receipt PALS sends.
-
Mail (limited sub-applications only). The Temporary Volunteer License – Dentist Only uses a PDF mailed to the Pennsylvania State Board of Dentistry, P.O. Box 2649, Harrisburg, PA 17105-2649. Include a check or money order for the applicable fee, and keep a copy of the full packet plus your certified-mail receipt as proof of filing.
-
In person and fax. The Board does not process the standard dentist application in person or by fax; walk-ins are directed back to PALS. For questions only, the Board sits at One Penn Center, 2601 N. 3rd Street, Harrisburg, PA 17110, reachable at (717) 783-7162.
Supporting documents like transcripts and exam scores often arrive separately, sent directly by your school and the testing agencies, so submit those requests the same day you file to avoid a gap.
What Happens After You File
After you submit, your file enters the Board’s review queue, and a licensing analyst checks each section against the documents on record. If everything matches, the Board approves your file and issues your license number, which then appears in the public license verification database. You can log back into PALS at any time to watch your application status change from Pending to Approved.
If something is missing or unclear, the Board emails a deficiency notice listing exactly what it needs. You respond by uploading the missing item in PALS, and the clock effectively pauses until you reply. This is why a working email and prompt uploads matter so much; a notice sitting unread is the most common cause of a slow file.
Once issued, your license is active and you may practice. Remember that the license is not permanent; you renew it every two years by March 31 of even-numbered years and complete 30 hours of continuing education, including 2 hours on abuse and neglect and 2 hours on opioid prescribing. Mark the renewal date the day you are licensed so it never sneaks up on you.
Mistakes to Avoid When Filling Out the Form
- Entering a nickname instead of your full legal name; this breaks the identity cross-check and triggers a manual hold.
- Transposing a digit in your Social Security number; this links your file to the wrong records and freezes issuance.
- Choosing the wrong licensure pathway; this loads the wrong checklist and can force a full restart.
- Forgetting to release your NBDE or INBDE scores; this leaves the Board with an empty record and a deficiency notice.
- Selecting the wrong clinical testing agency; this makes verification fail because the agency has no record of you.
- Skipping the Pennsylvania Dental Law Examination attestation; this stops the license from issuing entirely.
- Hiding a criminal conviction; this is treated as a false statement and can lead to denial.
- Uploading a non-approved child abuse training certificate; this earns an immediate rejection of that item.
- Using a school email that expires; this means you miss the deficiency notice and your file sits open.
- Listing a graduation date the transcript has not confirmed; this holds the file until the official transcript arrives.
- Omitting an old inactive out-of-state license; this looks like concealment when the Board’s data sharing finds it.
- Signing with initials instead of your full legal name; this voids the attestation and bounces the application.
Do’s and Don’ts
Do:
- Do gather every document before opening PALS, because a complete file moves fastest.
- Do match your name across the application, your SSA card, and your exam reports, because the Board cross-checks all three.
- Do request transcripts and score releases the same day you file, because they arrive separately and cause gaps.
- Do answer every disclosure question honestly, because false statements are punished harder than the underlying issue.
- Do save your PALS confirmation and email receipt, because they are your proof of filing.
- Do check your email often after filing, because deficiency notices arrive there and pause your file.
Don’t:
- Don’t guess at your pathway, because the wrong choice loads the wrong checklist.
- Don’t enter a placeholder Social Security number, because it links you to the wrong records.
- Don’t assume the national exam covers the clinical exam, because Pennsylvania requires both.
- Don’t skip the law exam because you are licensed elsewhere, because every pathway requires it.
- Don’t use a soon-to-expire email, because you may miss the notice that matters most.
- Don’t pay on a look-alike site, because only pals.pa.gov is the official portal.
Filing on Your Own vs. With Help
Many dentists file alone, while others use a credentialing service or an attorney, especially when there is a disclosure issue. Here is how the two approaches compare.
Pros of filing on your own:
- You save the cost of a service, because the PALS application is designed for self-filing.
- You control your own timeline, because you upload documents as soon as they arrive.
- You learn the system, which helps at renewal time every two years.
- You avoid sharing sensitive data with a third party, which protects your privacy.
- You can ask the Board directly at (717) 783-7162, because the staff answer applicant questions.
Cons of filing on your own:
- You carry the full burden of accuracy, because one error can cause a deficiency.
- You must track every separate document, which is easy to lose sight of.
- You may misjudge a disclosure question, because the wording can be tricky.
- You handle multi-state verification alone, which gets complex for endorsement filers.
- You have no advocate if the Board questions your file, which matters when there is a criminal or discipline history.
Frequently Asked Questions
Is there a paper dentist license application I can mail?
No. The standard dentist application is filed only through the PALS online portal. Paper is limited to a few sub-applications, such as the Temporary Volunteer License.
Is the Pennsylvania dental license application fee $260?
Yes. The dentist application fee is $260 under 49 Pa. Code § 33.3, reflecting the increase that took effect July 1, 2025.
Do I have to pass a Pennsylvania-specific law exam?
Yes. Every applicant, including endorsement and faculty filers, must pass the Pennsylvania Dental Law Examination on state rules at 49 Pa. Code, separate from any national board.
Do I write my maiden name or married name in the legal name field?
No. Use the name on your Social Security card and exam reports; list the other name in the Other Names Used field and upload your marriage certificate.
Does passing the INBDE cover the clinical exam requirement?
No. The INBDE is the written exam; Pennsylvania also requires a separate clinical exam from ADEX, CDCA-WREB-CITA, CRDTS, or SRTA.
Can I leave the Social Security number field blank for privacy?
No. State law requires your Social Security number for professional licensing, and the form will not submit without it.
Do I enter my foreign dental school as my qualifying degree?
No. Foreign-trained dentists enter their CODA-accredited advanced standing program as the qualifying degree and list the foreign degree separately.
Will an old criminal conviction automatically deny my license?
No. The Board weighs the context of each disclosure, and honest reporting usually matters more than an old or minor offense.
Can I switch my licensure pathway after I start the form?
No. Switching pathways often requires withdrawing and restarting, so choose the correct path before you begin.
Do I need official transcripts, or is self-reported education enough?
No. Self-reported education is not enough; the Board acts only on an official transcript sent directly by your dental school.
Can I practice as soon as I submit the application?
No. You may practice only after the Board approves your file and issues your license number, visible in the verification database.
Is the electronic signature in PALS legally binding?
Yes. The electronic signature carries the same legal weight as a sworn paper signature, including penalties for any false statement on the form.
Do endorsement applicants still need out-of-state license verification with a clean record?
Yes. Official verification from every state where you hold or held a license is required, even when your record is spotless.
How often do I renew my Pennsylvania dental license?
Yes, you renew every two years by March 31 of even-numbered years, completing 30 hours of continuing education including abuse and opioid topics.
Related reading
- How to Fill Out Pennsylvania LPN License Application (w/Examples) + FAQs
- How to Fill Out Pennsylvania Medical Board License Application + FAQs
- How to Fill Out Pennsylvania Osteopathic Medical License Application + FAQs
- How to Fill Out Pennsylvania Physician Assistant License (w/Examples) + FAQs
- How to Fill Out Pennsylvania Veterinarian License Application + FAQs
- How to Fill Out the Maryland Dentist License Application (w/Examples) + FAQs
- How to Fill Out Florida Medical License Application (MD) (w/Examples) + FAQs