Dentallusions


Request a Free video demonstration.
This offer is available to dental professionals only. Limit (1) per office.
Dentallusions reserves the right to reject any request that is incomplete or not in compliance with the above terms and conditions. * - required fields

Please send me a complimentary demonstration video.
Please send me a complimentary sample magic trick.


Name (First Last)*

Title*:
DDS
DMD
RDA
RDH
PHD
Other

Describe Your Role in Dentistry*:


Practice Name*

Type of Practice*:
General
Family Practice
Ortho
Endo
Pediatric
Other


Address*

City*     State*     Zip*


Tel.*     Fax


E-mail*


Have you used magic in your practice to entertain and put your patient's at ease?
yes no


How did you find out about our website? Check all that apply:

From a friend
Tooth Digest
Dental Products Report
Orthodontic Products
Dentistry Today
Radio Advertising
Television Advertising
Newspaper Advertising
Other


Would you like us to follow-up your request with a phone call?
Yes No

If 'Yes' when is the best time to call?


Comments:


Kit #1   |   Kit #2   |   Kit #3   |   Complimentary Offers   |   Order Form   |   Home
Dentallusions, Inc.
325 Park AvenueMahtomedi, MN 55115-1643
651-426-0059 or 800-LOUDINI   E-Mail: LOUDINI@AOL.COM