If you're a dentist and want to join to DENTAL World, complete the application form below in full and press the submit button at the bottom of this page to submit it.
I want to show my information in the following way: Basic, free Brief (u$s 50 per year) FULL, including an additional page (u$s 99 per year)
If you choice an option with fee, we will contact you soon to agree the payment method.
Select one specialty: (Hold the Ctrl button to select more than one) General Dentist Endodontist Oral Surgeon Orthodontist Pedodontist Periodontist Prosthodontist Is this an update of an existing listing? No Yes Name D.D.S. D.M.D. M.D. Ph.D. M.S. Address City State Country ARGENTINAAUSTRALIABARBADOSBOLIVIABRASILBULGARIACANADACHILECOLOMBIACOSTA RICAECUADOREGYPTEL SALVADORESPAÑAFRANCEGERMANYGREECEGUATEMALAHONDURASINDIAITALYISRAELLUXEMBOURGMEXICONEPALNETHERLANDSPAKISTANPANAMAPHILIPPINESPERUR.DOMINICANASUDANSWEEDENTHAILANDTAIWANTUNISIATURKEYURUGUAYUSAVENEZUELA Another Country (Not Listed) Zip Code Phone Fax E mail I will to add a link to DENTAL World. My URL Hours Mon Tue Wed Thu Fri Sat Sun Nearest Intersection Dental license numbers: Years in practice: Continuing Education: Membership in the following?(e.g., ADA) Will you be sending a logo or picture? No Yes Additional Services - Select all that apply (Hold the Ctrl button to select more than one) Autoclaves instruments and handpieces Office meets OSHA/CDC standards for infection control Wheelchair accessible Insurance accepted Available for 24 hour emergencies Computerized Medical Histories Headphones TV Digitized x-rays Intraoral camera General anesthesia IV sedation Cash accepted Credit cards Payment plans Check the following areas in which you wish to get referrals: (Hold the Ctrl button to select more than one) Root Canals (Endodontics) Extractions (Oral Surgery) Braces (Orthodontics) Children (Pedodontics) Gum Treatments (Periodontics) Crowns, Bridges and Dentures (Prosthodontics) Bleaching, Veneers and Bonding (Cosmetic Dentistry) Implants TMJ Comments about you This section is provided to give you the opportunity to tell a little about YOU (interests, philosophies, etc). Comments about your office This section is provided to give you the opportunity to tell a little about YOUR OFFICE.
After receiving full application DENTAL World reserves the right to reject or edit all applications.