Schedule Custom Shade

Custom Shade Scheduling

We would be happy to call your patient to schedule a custom shade...
Just fill out the form and we will contact them right away. We will open a case and expect an impression. If you need to schedule a pick-up, please do so from the Dr's Resource Page

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Dr/ Practice/ License Number *

Patient Name *

First

Last

Patient Phone Number *

Tooth Number/ Restoration Type/ Stump Shade *

Additional Comments *

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