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You must be ordering this material for a licensed dental practice. For information on how to get your teeth bleached visit our Patient Corner.

For pricing information, call us at (800) 543-3545.

Required fields are indicated with *.

Office Information
*Doctor Name:
License #:
State:
Order with us before? Yes No
*Your Name:
*Your Email Address:
*Office Phone:
*Street:
*City:
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*Zip:

Enter the quantity for each item you wish to order.

At-Home Whitening Kits - Price breaks occur in increments of six kits.
Cat.#ItemQuantity
503010% Carbamide Peroxide
Four 5.5cc Syringes
504015% Carbamide Peroxide
Four 5.5cc Syringes
505020% Carbamide Peroxide
Four 5.5cc Syringes
507030% Carbamide Peroxide
Four 5.5cc Syringes

At-Home Whitening Mini-Kits - Price breaks in increments of six kits.
Cat.#ItemQuantity
523010% Carbamide Peroxide
Two 5.5cc Syringes
524015% Carbamide Peroxide
Two 5.5cc Syringes
525020% Carbamide Peroxide
Two 5.5cc Syringes
527030% Carbamide Peroxide
Two 5.5cc Syringes

At-Home Whitening Bulk Syringes - Call for price breaks.
Cat.#ItemQuantity
513010% Carbamide Peroxide
One 5.5cc Syringes
514015% Carbamide Peroxide
One 5.5cc Syringes
515020% Carbamide Peroxide
One 5.5cc Syringes
517030% Carbamide Peroxide
One 5.5cc Syringes

Standard Bottled Gel - Price breaks occur in increments of 10 bottles.
Cat.#ItemQuantity
701010% Carbamide Peroxide - 2 Oz. Bottle
702015% Carbamide Peroxide - 2 Oz. Bottle
703020% Carbamide Peroxide - 2 Oz. Bottle
7110PerioFormula - 8% Carbamide Peroxide - 2 Oz. Bottle
7120PerioKit - 7110, 6080, 6090

In-Office Bleaching Material
Cat.#ItemQuantity
8000In-Office Kit
35% Hydrogen Peroxide Kit with full instructions
801044% Carbamide Peroxide
1 Oz. Bottle (incl. Enhancer)
802044% Carbamide Peroxide
Three 5.5cc Syringes (incl. Enhancer)
803535% Hydrogen Peroxide
5.5cc Syringe (incl. Enhancer)
804035% Hydrogen Peroxide, Superoxal
1 Oz. Bottle
8050No. 9 Bleaching Enhancer
1/4 Oz. Bottle

Support Materials
Cat.#ItemQuantity
6020Sponge Laminate
6030.040 Soft EVA
6040.080 Soft EVA
6050Storage Boxes
6070Kit Box, Stent Case, & Tote
6080Tongue Cleaner
6090Tripick Toothpicks
6110Tray Trimming Scissors
6130Dental Dam w/4 Tips

Marketing Materials
Cat.#ItemQuantity
9015Marketing Kit
9040Promotional Whitening Poster
9060Counter Cards - Pack of 5
9080Patient Brochures - Pack of 100
908130% Patient Brochures (pk of 100)
9090Statement Stuffers - Pack of 100
9100Zippered Tote Bags - Pack of 6
9110Patient Instruction Booklets - Singles
9120Waiting Room Whitener Newsletter

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Payment
We will call you, verify your order, and establish your payment method over the phone. We accept Visa, Mastercard, and COD.


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