Requests

Dental Health Products can be contacted in a number of ways to make a request — One Call Gets Us All!

Telephone

Toll-Free: 1-800-626-2163

Local: 1-920-866-9001

Fax

Local: 1-920-866-1865

Email

Email:

Register to receive exclusive Smart Email Deals

You must register to give us permission to send you exclusive Email Deals. The registration process is a snap! Please fill in the information fields below to complete the registration process and start receiving the Smart Email Deals today.

Register to Order Online

You must be a current customer of DHPI to order online. The process is quick and easy. Please fill in the information fields below to complete the Online Registration process and get all the benefits of ordering online through DHPI.

Note: If you experience any difficulty submitting this form to DHPI, you can email us directly at . Please include the information requested below. Thank you.

You must currently be a Dental Health Products customer to order online.

* = denotes a required field.

Request Type		Please select... Create an Account to Shop Online Request a Catalog Request a Service Call Request Handpiece/Small Equipment Repair Questions or Comments CMW12 *
Company/Practice Name		*
Title		Select One... Dr. Mr. Mrs. Ms Miss None *
First Name		*
Middle Initial
Last Name		*
Gender		Select One... Male Female
Job Function		Select One... Dental Assistant Dentist (Owner) Dentist (Partner) Dentist (Staff) Dentist Spouse Hygienist Laboratory Technician Office Manager Purchasing Agent Supply Coordinator Student Other *
Business Type		Select One... Dealer Federal Acct Laboratory Large Group Practice Small Group Practice Schools Solo Practice State/Institutional Acct Other *
Specialty		Select One... Dealer/Exporter Dental Assisting School Dental Hygiene School Dental Hygienist Dental Student Dental Technical School Lab: Crown/Bridge Lab: Denture Lab: Full Service Lab: Ortho Endodontist Prisons: Federal Prisons: State General Practice Implants Job Corps Military Multi-Specialty Non-Profit Oral Surgeon Orthodontist Pedo Perio Prosthodontics Public Health State/Local Govt. Veterans Admin Manufacturer Other *
Email Address		*
Confirm Email Address		*
Is this email address...		Select One... Business Personal *
Telephone Number		*
Telephone Extension
Cell Phone Number
Fax Number
Street Address		*
Suite, Apt. or PO Box
City		*
State		*
Zip/Postal Code		*
Country		*
Is this address...		Select One... Dental Office Residential Other *
What are you shopping for?		Dental Supplies Dental Equipment Technical Service and Repair General Office Supplies Practice Management Software Other
Email Specials		Yes, I would like to receive email specials from DHPI.     Text-only     HTML (some email programs do not accept this kind of message)
Mail Specials		Yes, I would like to receive mail specials from DHPI.
Current customers, please provide your customer number below.
Customer Number
Comments
		Please enter the code shown in the box to the left for security purposes.

• About DHPI
  • Mission Statement & Philosophy
  • One Call Gets Us All
  • Contact Information
  • Locations
  • Our History
  • Social Responsibility
• Customer Policy
• Terms and Conditions
• Privacy Statement
• Usage Agreement
• Press Releases
• Tool Kit
  • Go To Meeting
  • Vendor File Uploads
  • DenTrek Training
  • UPS Tracking
  • FedEx Tracking
  • Vendor Information
• Site Map
• Career Opportunities
  • One Call Gets Us All
  • Hiring Policies
  • Open Positions