Smile! Quality is Affordable!

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Dental Office: _____________________________ Customer #: ____________________ Date: _____________________

 

Shipping Address: ___________________________________________________________________________________

 

Tel: ______________________________________     Contact Person: _______________________________________

 

 

Description

QTY

Comment

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Surgical Aspirator Tip 25/PKG

MED (White)

 

Large (Green)

 

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High Volume Suction Tip 100/PKG

Blue                  Yellow

 

Pink

 

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Saliva Ejector 1000 / CTN

(10 Bags of 100)

 

 

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Mesh Bite Registration Trays

  1. Anterior Large 20/PKG

  2. Anterior Small 20/PKG

  3. Posterior Large 20/PKG

  4. Posterior Small 20/PKG

  5. Side less Posterior, 20/PKG

 

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Disposable Micro Brush 100/Barrel

 

 

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Gauze

2” X 2”

1000 / Box

 

 

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3 ply Bib

500 / CTN

Purple                  Blue

 

Green

 

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Irrigation Syringe

50 / BAG

 

 

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Impression Tray

10/Bag

 

 

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Wooden Wedge

Purple                  Blue

 

Orange                 White

 

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Barrier Film

1 Roll / Box

          

 

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Cotton Roll

1000 / Bag

(50 / Roll, 20 Roll/Bag)

 

 

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Clear Plastic Headrest Cover 250 / Box