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DEALER DIVISION - DENTREX TECHNOLOGIES - REQUEST FORM

 

Thank you for your interest in becoming a Dealer / Wholesaler. Please complete the the application below in its entirety. A wholesale price list will be emailed after your application is approved. Distributor Catalog

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Contact/Company Information
Contact Person: E-mail * : Website * :


Billing Information (Use address that appears on your credit card or bank statement)
First Name * : Last Name * : Company * :
Address:
City State: Zip/Postal Code:
Country: Phone Number * :


Shipping Information (Only required if different from Billing Address)
First Name: Last Name: Company * :
Address:
City State: Zip/Postal Code:
Country: Phone Number:


Bank Information (Only required if different from Billing Address)
Bank Name: Phone: Country:
Address:
City: State: Zip/Postal Code:
Tax ID:
     
     
   
     

Dealer / Wholesaler Terms and Conditions

  • A Dealer Application must be approved prior to placement of first order.
  • Orders must be prepaid via Visa, MasterCard, American Express or Discover.
  • Purchase Order terms can be extended at our discretion to dealers / wholesalers with regular buying history and minimum credit requirements.
  • Dealer / wholesalers pricing is subject to change without notice at any time.
  • Dealer / wholesalers must meet Internet shopping cart minimum order requirements.

For questions or more information, please contact:
Lisa Wassmer
Director of Sales
800 257 5782
856 795 6199
lisawassmer@visionusa.biz




 



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