ONLINE FORM FOR 2 DENTURES

2 EASY STEPS

1: Fill out the form below
2: Pay online

STEP 1

First name

Last name

Phone

Street

City

ZIP Code

State

Country

I am already using 2 complete dentures, above and below.

Yes

I would like to receive the “Apprenteeth” kit at $ 840 (including the acrylic transformation process, to be carried out by a dental laboratory, in order to receive my final new dentures).

Yes

Send me a pair of gloves in case someone helps me

Choose the shape of the teeth from the attached chart

Choose the color of your teeth from the chart included in the kit

By submitting this form, I accept that the information entered will be used in the context of the contact request and the commercial relationship that may occur as a result.

Yes

In order to know, understand and exercise your rights, and specifically the right to withdraw your consent to the use of the data collected by this form, please consult our privacy policy.

Choosing the color
of your teeth

The vast majority of people choose A1, B1 or A2, when ordering 2 dentures.

Here is the range of shapes and colors available:

Click on the image to enlarge.

ONLINE FORM FOR 2 DENTURES

2 EASY STEPS

STEP 1

Choosing the colorof your teeth

Choosing the color
of your teeth