Direct Partnership

Join Our Network

Initialize your practice within our digital infrastructure. Complete the form below to begin your integration.

Practice & Contact Information

Practice Affiliation *

Practice / Clinic Name *

Customer Status

Doctor's First Name *

Doctor's Last Name *

Doctor's Email *

Doctor's Phone Number *

Office Manager's Name

Office Manager's Email

Office Manager's Phone Number

Preferred Communication Method

Phone

Text Message

Additional Doctors / Associates

Street Address

Address 2

City

State / Region

Postal Code

Impression Method

Intraoral Scanner Used

Additional General Practice / Clinic Notes

Billing Account Setup Preference

DSO Month-End Statements Preference