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Hint: The password should be at least seven characters long. To make it stronger, use upper and lower case letters, numbers and symbols like ! " ? $ % ^ & ).
By checking this box, you hereby indicate that you represent a Dental Practice or Clinic.
If you are a dental professional, please enter the following information to receive a discount. Upon completion of this form, you will be eligible for the discount. Any orders from new accounts are verified before processing.
Name of Practice / Clinic:
Office Address 1:
Office Address 2:
State / Province:
Our customers frequently ask for local retailers or Dentists that may carry our products. By checking this box, you give us permission to forward such patients to your clinic, so that they can obtain more information about, or purchase, TGuard products.
You can opt out at any time.
Please enter your profession, i.e. dentist, pediatrician, orthodontist, speech pathologist, etc.
What type of Health Professional are you?
Registration confirmation will be emailed to you.
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