Request A Quote:
Please fill out the request form in detail to request a quote or other service request. Be sure to click 'Send My Request' when finished (fields marked with '*' are required). You can also use these alternate means of contacting us below:
Our
'Contact Us'
Page
Toll-Free: 1-877-879-0165
Fax: (570) 296-2706
E-Mail:
dhhe@ptd.net
Your Name*:
Office/Business Name*:
Phone*:
Fax:
E-Mail*:
Address:
Addt'l Address/PO Box:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AA
AE
AP
AS
FM
GU
MH
MP
PR
PW
VI
Zip Code:
Instrument Type (if applicable):
Manufacturer (if applicable):
Model / Serial # (if applicable):
Related to which of our product or service offering(s) ?:*
REPAIR SERVICES: Dental or Surgical Handpiece, Ultrasonic Scaler, or Other
PURCHASE INQUIRY: New or Preowned Dental or Surgical Product
INSTRUMENTS: Sharpening/Retipping Services
OTHER Product or Service Inquiry (Please Describe Below)
Please choose the situation which best describes your need:
URGENT: My Current Poductivity Is Being Impacted To A Great Degree
NORMAL: I Have A Need Daily For This, But I Am Still Managing To Be Productive
FUTURE: I Am Planning for A Future Daily Need or Growth/Expansion
OTHER (Please Describe Below)
My contact preferences are:
PHONE - Call or Fax Me
My E-MAIL Address
My MAILING ADDRESS
Please enter the details of your request below. Be specific and include as much detail as possible. This will help us to respond more quickly:*
Additional information or comments as needed:
