Phoenix Dental  Inc.

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To place an order call us at 1 877 463-9905 (Toll Free within the USA)
or you can order on-line with the form below

I would like to Order.......
FDA regulates this product can be supplied to dental offices ONLY!  We can not provide product to a non-dental office!

100298 (Super Seal 8ml bottle-approximately 160 applications)$80.00 each- Order 3 bottles and receive a FREE 3ml bottle

I would like 8ml Bottles

(Super Seal 4ml bottle-approximately 80 applications) Price:$49.95 each- Order 5 bottles and receive a FREE 3ml bottle

I would like 4ml Bottles

*S&H is $6.50 per order(shipped priority mail)

Please Send It to.......

* Your Name:
*Dentist's Name:
*Dentist Office:
* Address
* City
* State:
* Zip Code:
* Country:
* Phone:
Fax:
* E-mail:
Comments:

Payment

Visa/Mastercard We don't currently have secured web transactions. After you complete your order one of our Friendly staffers will call you at their earliest convenient. (This is only temporary! Sorry for the Inconvenience.)

Check Make checks payable to:

		Phoenix Dental
		11224 Phoenix Dr.
		Fenton, MI 48430

NOTE: * Denotes Required Fields.