Inquiry Form (to Export division only)

*Required information

This inquiry form is intended for those interested in our product lines. Kindly note that we are unable to respond to business contacts unrelated to our products.

Name *

Salutation

First

Last

Company name *

Country *

Phone number

Website

E-mail Address *

Confirm E-mail Address *

Purpose of contact *

I am interested in becoming a distributor.
I am a doctor and interested in purchasing products.
I need spare parts.
Others (If others, please specify in comment section.)

Product of interest *

Dental Unit
X-ray Equipment
Laser Equipment
Dental Handpieces
Spare Parts (please specify the product name in comment section.)
Others (if others, please specify in comment section.)

How did you hear about us? *

Search Engines (e.g. Google, Yahoo, Bing)
Dental Exhibition
Facebook
Medical Expo
Word of Mouth
You either own or used to own our products.
Others (if others, please specify in comment section.)