Account Registration Page | Independent Dental Supplies

Open Account Registration

If you would like to apply for an account, please fill out the application form below and we will be in touch.

Please note we only supply New Zealand businesses.

Email for accounts *

Email for accounts is missing

Practice name *

Practice name is missing

Company Name *

Company Name is missing

NZ company number *

NZ company number is missing

Owners name *

Owners name is missing

Owners contact number

Owners contact number is missing

Practice phone number

Practice phone number is missing

Delivery address *

Delivery address is missing

Email for order confirmation *

Email for order confirmation is missing

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