GET A QUOTE

It’s easy to learn how much you might save by obtaining your professional liability coverage through Doctors' Professional Liability Insurance Agency, a d/b/a of Medical Professional Liability Agency, Ltd. (MPLA). Simply complete and submit the form below to receive a free, no-obligation quote.

CALIFORNIA DENTISTS

Contact Penny Mantzouratos
1-800-822-8260 x5995
pmantzouratos@medmalagent.com
Fax: 1-800-763-3776

Questions or Comments?
First Name:
Last Name:
Specialty:
Street Address:
City:
 State: Zip:
County:
Phone:
- - ext.
Fax:
- -
E-mail Address:
Best Way To Contact You:
 Phone Fax Mail E-Mail
Best Time To Call:
Refer-A-Friend:
  I Was Referred By:
Address:
City:
State:    Zip:
Phone:
Current Coverage :

Claims Made (retro date: ) OR
Occurrence
Limits $ /$
Number of Locations:
Expiration Date:

Desired Coverage :

Claims Made (retro date: ) OR
Occurrence
Limits $ /$
Number of Locations:
Effective Date:

How many years have you been practicing?: Years
Have you had any claims in the last 10 years?: Yes No
If Yes, are there any open claims?:

Questions or Comments:

Customer Service & Questions
Ari Mir 1-800-822-8260 x5548, fax: 1-800-763-3776
Doctors' Professional Liability Insurance Agency
P.O. Box 859 Rock Hill, NY 12775

Privacy Policy | Terms of Use
© 2007 Doctors' Professional Liability Insurance Agency