JULY 2013
CONTENTS • Medicaid Managed Care Update • TDA Perks
- Perks Inaugurates Educational, Networking Program for Staff
• TDA Smiles Foundation - Texarkana TMOM - Abilene TMOM - Join The 100 Club TODAY! • TDA Member Spotlight
- Dr Joseph Torres, El Paso
• EDitorial • President’s Statement • TSBDE Rule Update
July Texas Dental Journal Dental Implants
Around the State August 2-3 Dentists Who Care Conference South Padre Island August 9-10 TDA Smiles Foundation Texas Mission of Mercy Texarkana August 16-17 TDA Board of Directors meeting Austin Using your smart phone, scan this QR code to access the TDA Today on TDA.org.
VOLUME 14, ISSUE 7
AVAILABLE ON TDA.ORG
83rd Texas Legislature: Spotlight on House Bill 3201 As reported in the June 2013 issue of TDA Today, the recently concluded 83rd regular session of the Texas Legislature resulted in passage of legislation that will impact every dental practice in the state. The legislation highlighted in last month’s TDA Today awaited action from Governor Rick Perry. The TDA is pleased to report all bills listed were signed by the Governor and all will become law (ie, House Bill (HB) 500, HB 3201, HB 2483, Senate Bill (SB) 1803, HB 1491). As mandated by the House of Delegates, the TDA actively pursued a robust legislative agenda on behalf of Texas dentists and patients. A priority item for organized dentistry was an effort to enhance patient protection and safety at entities not wholly-owned by dentists who provide patient care. Dental Service Organizations (DSOs) in Texas continue to increase in number, size, and volume of patients treated as do accounts of profit-over-patient business practices that can lead to patient abuse and mistreatment. The TDA worked closely with the legislature during the 83rd session to advocate in favor of creating reasonable safeguards for patients who seek care at DSOs and dentists who work with/for DSOs. Working with key members of the Texas Senate and Texas House, SB 151 and HB 1480, which were identical bills, were filed. The legislation required DSOs to register with the state, pay a fee, and submit information regarding ownership, locations, and dentists who work with/for them. It also included punitive actions for violations and other items aimed to protect patients. The effort was met with sharp opposition on behalf of most DSOs that operate in the state. The resistance began the moment the bills were filed and continued, unabated, until the final days of the regular session. In the end, organized dentistry prevailed with passage of HB 3201 by Rep Lois Kolkhorst (R – Brenham) and Sen Jane Nelson (R – Flower Mound). HB 3201 was amended during the legislative process to include many of the concepts introduced in SB 151/HB 1480. Rep Kolkhorst and Sen Nelson chair House/Senate committees that oversee dentistry, and both were instrumental throughout the session in working with the TDA to enhance patient protection and safety. The following provides a summary of HB 3201, which is now law. The legislation: • Defines in law a DSO; • Defines in law a service agreement made between a DSO and a dentist; • Allows a parent/guardian of a child to be present in the treatment room while the child receives treatment but only if the dentist permits it; • Requires dentists (licensees) to submit the following information to the Texas State Board of Dental Examiners (TSBDE) upon issuance and annual renewal of their license effective January 1, 2014: - The number and type of dentists employed by the license holder, if any; - The name under which the license holder provides dental services and each location where those services are provided; - Whether the license holder participates in the Medicaid program; - Whether the license holder is employed by or contracts with a DSO and, if so, the name and address of the DSO; - Whether the license holder owns all or part of a DSO and, if so, the name and address of the DSO and the location of each office; - Whether the license holder is party to a dental service agreement and, if so, the name and address of the DSO that provides services under the agreement; - If the license holder owns all or part if a DSO, whether that practice is a party to a dental service agreement and, if so, the name and address of the DSO that provides services under the agreement. - In addition, the TSBDE may request that a DSO provide to the TSBDE the address of the locations where the organization provides dental services and the name of each dentist providing dental services at each location. • Establishes an expert panel at the TSBDE to assist the board with complaints and investigations relating to professional competency of dentists and hygienists; - The expert panel must complete a preliminary investigation of a complaint not later than the 60th day after the complaint is received; • Increases the annual dental license fee by $55 to cover costs associated with the creation of the expert panel; • Prevents TSBDE board members while serving on the board from testifying as expert witnesses in standard of care cases. Full text of HB 3201 may be found at tinyurl.com/HB3201.
TDA Holds Leadership Conference Almost 60 representatives attended the TDA Leadership Conference on Friday, June 21, 2013, in Austin. TDA President Dr David A. Duncan facilitated the 1-day conference, hosted by TDA Financial Services, Inc. (TDA Perks).
Component society executive directors attend the TDA leadership conference in June: Lisa McLerran - North Texas, Linda Shafer - San Antonio, Tiffany Groothuis - East Texas, Nancy Nisbett - Central Texas, Jane Evans - Dallas, and Susan McKee - Houston.
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About 60 component presidents, presidentselect, council and committee chairs, component executive directors, and members of the TDA Board and staff attend the TDA Leadership Conference in Austin on Friday, June 21.
The conference combined meetings of the TDA Presidents-Presidents-elect Conference, the TDA Council, Committee and Affiliate Training, and the TDA Component Society Presidents Committee. The morning session included presentations from TDA Perks and the TDA Smiles Foundation. In the afternoon, attendees heard presentations from TDA legal counsel and Dr Richard Black, chair of the TDA Council on Legislative and Regulatory Affairs. Dr Phil Nauert, chair of DENPAC, reported on the current activities of DENPAC and the necessity for donations. Following his presentation, conference attendees donated approximately $8,000 to the PAC. Also in the afternoon, Dr Duncan held a break-out session for new council and committee chairs and members and discussed their roles and duties. TDA President-elect Dr David McCarley conducted a roundtable discussion with the TDA Component Society Presidents Committee.
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Texas Dental Program Medicaid/CHIP As of July 1, 2013, Texas adjusted the reimbursement rates for 9 Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) dental procedure codes in traditional Texas Medicaid. Prior to the Health and Human Services Commission’s (HHSC) final decision to adjust the rates, the Texas Dental Association (TDA) testified before HHSC’s rate setting committee expressing concern that a reduction to D9248 — non-intravenous conscious sedation — could result in severely limiting access to this level of sedation. Readers may find a complete listing of the EPSDT codes reduced and the new fee schedule for the selected codes on the TDA’s Medicaid/CHIP Website at tda.org.
TDA life member Samuel O. Dorn, DDS, of Houston was awarded the Edgar D. Coolidge Award by the American Association of Endodontists (AAE) at the organization’s annual meeting in Hawaii in April 2013. This accolade is the AAE’s highest honor and lifetime achievement award. Dr Dorn is a former president of AAE, and he currently serves as the chairman of the Department of Endodontics at The University of Texas Health Science Center at Houston (UTHealth) School of Dentistry. He holds the Frank B. Trice, DDS, Professorship in Endodontics at UTHealth and was the founding director of the postgraduate endodontics program at Nova Southeastern University College of Dental Medicine. Dr Dorn also served as a clinical professor at the University of Florida School of Dentistry and has authored numerous articles and textbook chapters.
Pictured is April Cobb of the Alliance of the TDA who was one of 4 2013 Spencer award winners! The photo was taken in Branson, MO on April 19, 2013, during the Alliance of the ADA’s annual Conference.
Dentists participating in one or both of the
Evidence-Based Practice Tip of the Month Stephen R. Matteson, DDS, FICD, TDA Editor
TRIP Database Take a few minutes and search the TRIP Database (tripdatabase. com) and enter “maxillary sinus dental infection.” I found a number of interesting articles such as: J Am Dent Assoc. 2005 Jul;136(7):921-5. Intraorbital abscess: a rare complication after maxillary molar extraction. Stübinger S, Leiggener C, Sader R, Kunz C. PMID 16060473 Laryngoscope. 2009 Mar;119(3):580-4. doi: 10.1002/lary.20095. Frequency of a dental source for acute maxillary sinusitis. Bomeli SR, Branstetter BF 4th, Ferguson BJ. PMID 19160401.
The Beulah K. Spencer Service Award is a Distinguished Service Award that recognizes members who make outstanding contributions and who exemplify outstanding leadership and volunteer spirit through excellence in service and commitment to their Alliance on the component (local) level and/or constituent (state) level. Established in 1994, this prestigious award honors Beulah K. Spencer. Candidates must have been active tripartite members or members-atlarge 10 years or less.
state’s dental plans (DentaQuest and MCNA Dental) will be reimbursed for the affected dental codes at rates set by the dental plans. The TDA is disappointed by HHSC’s decision to reduce the reimbursement rate for D9248 and will continue its advocacy efforts to have the reimbursement rate increased. The TDA’s next quarterly meeting with the dental plans is scheduled for August 1, 2013, and the Association wants to hear from you! Email your feedback about the dental plans to TDA Policy Manager Diane Rhodes at diane@ tda.org before July 16, 2013. Recently,
DentaQuest
mailed
letters
to
certain contracting providers describing a 2% reduction in its Medicare NOT Medicaid
Member Get A Member
program. There has been no reduction to DentaQuest’s Medicaid fees.
Building the future of our profession … together!
Share why you belong
to the #1 organization representing all dentists. Any ADA member dentist is eligible to participate in the 2013 ADA Member-Get-A-Member Campaign. With your help: • The ADA benefits by representing another member dentist.
Perks Inaugurates Educational, Networking Program for Staff
• The new member you recruit benefits by taking advantage of membership. • You benefit by strengthening the ADA and sharing membership with another colleague — plus there are incentives and prizes for recruiters! For details and complete campaign rules visit ADA.org/MGAM.
educational and networking program for office staff on August 15, 2013, from 3:30 PMTDA-member staff will enjoy complimentary admission and hors d’oeuvres and learn about
compliance
training,
generating
passive revenue, and supply management. Representatives of Perks programs Smart Training, LLC, Philips Sonicare and Zoom!, and The Glove Group will present short programs, and office staff will have the opportunity to
The ADA Member-GetA-Member campaign runs through September 30, 2013. For resources to assist your recruiting efforts, plus complete guidelines and rules visit ADA.org/MGAM, send an email to mgam@ada.org or call 800.621.8099.
happy healthy smiles... that’s our mission!
TDA Perks Program is hosting its first
6:30 PM at the Dallas County Dental Society.
Don’t Delay!
Texarkana TMOM
On August 9-10, 2013, Texarkana will host its second Texas Mission of Mercy (TMOM) event. This 20-chair, 2-day TMOM will be supported by CHRISTUS St. Michael, continuing a partnership that began in 2011. At the first Texarkana TMOM, 44 dentists from all over Texas volunteered to treat 532 patients, providing more than $438,000 worth of charitable care.
Abilene TMOM
On October 4-5, 2013, Abilene will host its first TMOM event. Please consider signing up for this exciting, 40-chair, 2-day event! TMOM events depend on the generous involvement of Texas dentists. To sign up to volunteer for upcoming TMOM events, or to make a monetary contribution to support TDASF’s efforts, please visit tdasf.org.
network with their peers. This program is recommended for privacy policy officers, office managers, dental assistants, and front office staff. To register your staff, please call 512-443-3675 and ask for Josh Epstein.
JULY 2013 • TDA Today • 2
Join The 100 Club TODAY!
You may not realize it, but you have an amazing gift. You have the ability to change someone’s life. There are thousands of Texans in both urban and rural communities who either cannot afford or access even the most basic dental care. Some have spent years in discomfort, being unable to chew and eat healthy foods, suffering with illnesses brought on by lack of dental care, and living with the unbearable pain that often accompanies poor oral health. That is where you come in. By supporting TDASF, you will be changing —and possibly saving — the lives of thousands of your fellow Texans. Whether it is a 1-time contribution or your commitment to become a sustaining giver or 100 Club Member, you are helping change lives. Please contact TDA Smiles Foundation Manager Judith Gonzalez at judith@tda.org and pledge to support the foundation’s mission to improve access to dental care for citizens of Texas.
President’s Statement David A. Duncan, DDS, TDA President
In this issue of TDA Today you will see the majority of the information focused upon our recent legislative session. The first thing I want to say is, “TDA members are the luckiest members represented on the hill, and it is all because of the staff and volunteers who take our message to the legislators”. From our legislative department to our legislative consultants to our Council on Legislative and Regulatory Affairs, TDA has assembled one of the finest teams “practically no money” can buy! Their expertise on the subject of dentistry and how the political system works is second to none.
TDA MEMBER
SPOTLIGHT Joseph Torres, DDS — El Paso, Texas “No te rajes.” Translated, the Spanish phrase means, “Don’t give up.” That’s the motto by which Dr Joseph Torres of El Paso lives his life. He forges ahead, and he has lived many lives during his 9 decades.
This session saw highs of legislators clamoring to carry our bills to the lows of legislators taking our bills and then allowing no action on them. In the end, our legislative consultants got our key issues before both the House and Senate, and we saw favorable outcomes on almost all of our causes. I am reminded of a line from the movie Charlie Wilson’s War: “Why is congress saying one thing, and doing nothing? Well, tradition mostly!” Luckily at TDA the tradition is to not only say, but to do. And that’s what your team is good at …
ED
itorial: Thoughts from Your ED
Aaron Washburn, TDA Executive Director
A good association is always evolving and transitioning. Not only in developing new tools, programs, and services to meet the changing needs of its membership, but also in electing new leaders. Annual elections bring new blood and new ideas to all levels of the tripartite. TDA’s new leadership gathered in Austin in June to receive orientation and prepare for the tasks of leading the association. New TDA Board members, as well as presidents and presidents-elect from each component, and TDA council and committee members discussed the issues facing the association, shared ideas, and discussed how to meet the mission of the association.
Ninety-year-old Dr Joseph Torres and his partner Dr Guadalupe Ward, both TDA members, stay abreast of current dental technology and advancements, he says.
Dr Torres, 90, was born in El Paso. A family dentist suggested he study dentistry instead of engineering, and he graduated from Creighton University School of Dentistry in Omaha, Nebraska, in 1952, returning to El Paso shortly after. He has been married twice and has 7 living children.
Prior to practicing dentistry, Dr Torres was like many of the G.I. Generation during World War II. He flew as a bombardier on a B-17 Flying Fortress while serving in the U.S. Army and the U.S. Army Air Corps in the American and European theaters from 1942 to 1945. He was honorably discharged when the war ended and is still involved with veterans groups. His service in the military and other life experiences help him treat his patients, he says. When he was 45, he had a serious car accident that left him in a coma with retrograde amnesia. He forgot the memories of life with his first wife and children, and he had to learn to live with its effects. “It’s the darnedest thing,” he says of suffering from amnesia. “But, we don’t have time to feel sorry for ourselves.” Making the most of a bad situation is his guiding principle. “Si se puede,” he says. “Yes, it’s possible.”
This year’s TDA Leadership Conference (sponsored by TDA Perks Program) also included a meeting of the executive directors of the staffed component societies. The meeting allowed societies to share best practices, and work to alleviate overlap of services between the state and component levels. The discussions by this group were good, and I hope the information shared leads to discussions with local leadership in the future. All of those in attendance shared their desire to see TDA continue to thrive and focused on how we can best serve our members. We are all in this together. The conference was a great reminder of the importance of team spirit and sharing a common goal. I, for one, left energized and excited about the TDA’s future. Thanks to all of the doctors who came and all who dedicate so much time to this organization and their profession.
MEETYOURSTAFF
Leigh Leigh Ann is the manager of DENPAC, the Ann Texas Dental Association Political Action DENPA Montague C Man Committee. DENPAC’s goal is to helps elect ager responsive candidates who understand the important role dental health plays in our communities. After just wrapping up the 83rd Legislature, Leigh Ann will soon be gearing up for yet another election cycle. As most of you know, when the legislation session ends, the campaigning begins. Where did you grow up? I grew up in the hill country in Wimberley, Texas. Population: Extra small!
Where did you go to school and what did you do before you came here? I attended Southwest Texas State University where I received a bachelor’s degree in marketing. During and after college, I worked in commercial property real estate for more than 10 years.
Why did you decide to come to the Texas Dental Association? I met Susan Ross, former TDA director of public affairs and current TDA legislative consultant. Susan’s overwhelming enthusiasm for her job made changing careers seem like an exciting challenge. With the economy beginning to take its toll on the real estate industry combined with an opportunity for change, I applied for the position of political action committee manager.
As a result, he feels he has the interpersonal skills to compassionately treat his patients, including present-day soldiers suffering from post traumatic stress disorder, many of whom he sees in his own home rather than in the office. Dr Joseph Torres of El Paso, known affectionately as Dr Joe, is pictured with current and past staff members at his 90th surprise birthday party in April 2013. One-hundred-fifty patients, doctors, staff members, and friends celebrated Dr Torres’ birthday with him.
Dr Torres is a life member of TDA and still practices 35 hours a week. The changes he has seen in the profession have been enormous, he says. “I always said it takes 10 years after dental school to become a better dentist, and the changes are coming more rapidly at us now.”
He says the advent of the ceramic crown was one of the most influential changes for him in the profession. In the 1980s, he acknowledged the rise of cosmetic dentistry and focused on learning more about composites to begin phasing out amalgam. “I try to be as current as possible. I haven’t gone into digital radiography yet, but my partner (Dr Guadalupe M. Ward) has.” This nonagenarian is not thinking of retiring anytime in the near future. “I love people. It’s a challenge, but I still have all my teeth, including my wisdom teeth. Maybe that makes me more knowledgeable,” he laughs. Dr Torres is thankful for the profession that has meant so much to him. “The Lord has been very good to this old man.” This recurring section highlights the lives of TDA members outside of the office. If you have an interesting story about yourself, if you are working on a project that your peers might find interesting, or if you have a hobby that keeps you busy, please contact TDA Managing Editor Nicole Scott, nicole@tda.org, 512-443-3675.
Your DENPAC Contribution Is Worth More with Your TDA Perks Credit Card!
Use your TDA Perks Credit Card to make your 2013 DENPAC contribution, and you’ll support TDA in 2 ways, instead of 1. In addition to supporting dental advocacy, you’ll help raise non-dues revenue for TDA! In order to receive DENPAC membership recognition in the directory issue of Texas Dental Journal, you must make your contribution by the end of July.
What is your favorite thing about the job? By far, my favorite thing about my job is hosting events. Everyone who knows me knows that: 1. I love to talk, and 2. I love to plan. Hosting events for our members is what I look forward to all year. I love coming up with new and sometimes unusual ideas and then seeing our members get an opportunity to mingle and enjoy time with their colleagues.
What is one thing about you that might surprise people? I own more power tools than most construction workers. Before I was born, my dad was a contractor, and growing up I wanted to be just like him. Once I realized that meant enduring 105o heat for more than half the year, that dream quickly changed; although, it didn’t stop me from establishing a huge collection of tools with which I handle most of my own home repairs.
Visit denpac.org to become a DENPAC member! Visit tdaperks.com (Programs for Your Practice/Credit Card) to apply for your TDA Perks Credit Card. For more information, call 800-932-2775. Mention priority code: VABQ92.
APPLY TODAY!
TEXAS DENTAL ASSOCIATION POLITICAL ACTION COMMITTEE
TSBDE Rule Update
This recurring section is designed to help TDA members keep up with important Texas State Board of Dental Examiners (TSBDE) rules, other regulations, and state law affecting their practices.
In January the Texas State Board of Dental Examiners (TSBDE) adopted new Business Promotion (ie, advertising) rules. These rules will take effect September 1, 2013. This update is the sixth and final update in a series of articles devoted to summarizing the new rules.
Advertising Requirements Website Disclosures
A dentist can promote his or her dental practice through a website, as long as the site includes the practice address and contact information, as well as the licensure and qualifications of the dentist(s) and allied personnel providing services. Furthermore, the owner of the website must be clearly stated on the site.
Grounds and Procedures for Disciplinary Action for Advertising Violations
The board has broad authority to discipline licensees who commit advertising violations. The punishment could range from a warning or reprimand, to license suspension or revocation. It is important to note that failing to retract or correct adverting violations as directed by the TSBDE may be seen as an additional violation and could subject the licensee to further disciplinary action.
Awards, Honors, and Recognitions
A dentist can include receiving a professional award, honor, recognition, or rating in his or her advertisement. These statements must be truthful, subject to verification by the public, and include the specific year or time period, awarding organization, and a listing of other licensees (if applicable). The board provided additional clarification to this section by providing examples of what is and is not acceptable: Proper: John Doe, DDS — Included in Anytown Quarterly’s Fall 2012 Top Dentists Improper: John Doe, DDS — Top Dentist Proper: John Doe, DDS — Selected as Anytown’s 2012 Dentist of the Year by the Anytown Improper: John Doe, DDS — Dentist of the Year Proper: John was selected for inclusion in 2012 Anytown Yearly’s Super Dentists List Improper: John is an Anytown Super Dentist The rule further restricts that an individual dentist’s award may not be attributed to an entire practice or be received by the dentist in exchange for providing money.
Advertisement and Education by Unlicensed Clinicians
EDITORIAL STAFF Stephen R. Matteson, DDS, Editor Nicole Scott, Managing Editor Lauren Oakley, Publications Coordinator Barbara Donovan, Art Director Paul H. Schlesinger, Consultant Board of Directors David A. Duncan, DDS, DDS, President David H. McCarley, DDS , President-elect Michael L. Stuart, DDS, Immediate Past President Vice Presidents Jean E. Bainbridge, DDS, Northeast Gregory K. Oelfke, DDS, Southeast Yvonne E. Maldonado, DDS, Southwest David C. Woodburn, DDS, Northwest Senior Directors Jerry J. Hopson, DDS, Northeast William S. Nantz , DDS, Southeast Joshua A. Austin, DDS, Southwest Steven J. Hill, DDS, Northwest Directors William H. Gerlach, DDS, Northeast Karen A. Walters , DDS, Southeast John B. Mason, DDS, Southwest Charles W. Miller, DDS, Northwest Ron Collins, DDS, Secretary-Treasurer John W. Baucum III DDS, Speaker of the House Michael D. Vaclav, DDS, Parliamentarian Stephen R. Matteson, DDS, Editor Aaron Washburn, Executive Director William H. Bingham, Legal Counsel TDA Today (USPS 022-007) is published monthly except for December by the Texas Dental Association, 1946 S IH-35 Ste 400, Austin, Texas 78704-3698, 512-443-3675. Periodicals Postage Paid at Austin, Texas and at additional mailing offices. POSTMASTER: Send address changes to TDA TODAY, 1946 S IH-35 Ste 400, Austin, TX 78704-3698. Annual subscriptions: Texas Dental Association (TDA) members, $5. In-state American Dental Association (ADA) affiliated, $15 + tax. Out-of-state ADA affiliated, $15. In-state non-ADA affiliated, $30 + tax. Out-of-state non-ADA affiliated, $30. Single issue price: TDA members $1. In-state ADA affiliated, $3 + tax. Out-of-state ADA affiliated, $3. In-state non-ADA affiliated, $6 + tax. Out-of-state non-ADA affiliated, $6. Contributions: Manuscripts and news items of interest to the membership of the Association are solicited. Manuscripts should be typewritten, double spaced, and the original copy should be submitted. Please refer to Instructions for Contributors in the annual September Directory of the Texas Dental Journal for more information. The Information for Contributors is available at tda.org. All statements of opinion and of supposed facts are published on authority of the writer under whose name they appear and are not to be regarded as the views of the Texas Dental Association, unless such statements have been adopted by the Association. Articles are accepted with the understanding that they have not been published previously. Authors must disclose any financial or other interests they may have in products or services described in their articles. Advertisements: Publication of advertisements in this publication does not constitute a guarantee or endorsement by the Association of the quality of value of such product or of the claims made of it by its manufacturer.
An out-of-state licensed dentist may not advertise in Texas unless the advertisement clearly discloses that he or she is not licensed to practice in Texas. The information in this TSBDE Update came from 22 Texas Administrative Code §§108.59, 108.61, 108.62, and 108.63. For more information, please contact TDA Policy Manager Diane Rhodes at 512-443-3675, diane@tda.org.
JULY 2013
VOLUME 14, ISSUE 7
AVAILABLE ON TDA.ORG
FREE PRIVACY COMPLIANCE WEBINAR SERIES From the company that brought you Perksʼ Popular HB300 Compliance Training Program TDA Perks Program partner, Smart Training LLC, is offering TDA members a free, 3-part lunch-hour webinar series, “Anatomy of Data Breaches: What to do if and when they occur.” Inform yourself and your staff on how to be compliant with HIPAA/HITECH, and have your questions answered. Learn about business-associate agreements, risk-management responsibilities, and compliance-training requirements. Each program will begin on a Wednesday at noon and end at 1 p.m. Part I: July 31st Part II: Aug. 14th Part III: Aug. 28th
For more information or to register, visit tdaperks.com in mid-July.
More at: tdaperks.com Questions? Call: (512) 443-3675.