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BUY $2,000 in Eligible Practice Essentials Products, GET 1 - Smartlite Focus Curing Light, Midwest® High Speed Handpiece or Attachment, Nupro Freedom® Cordless Prophy Package (L01), or Nupro® RDH Hygiene Handpiece AT NO ADDITIONAL CHARGE
Eligible Brands: First Bite®, Jeltrate®, Jeltrate® Plus, Jeltrate® Chroma, Compules® Tip Syringe Gun, Caulk® Tooth Conditioner, Snap-A-Ray®, Uni-Grip®, XCP®, XCP-DS®, XCP-DS® FIT™, XCP-ORA™, ComfortWand™, ASSURE Plus™, Com-Fit®, FlashTips™, Purevac® SC, ReSURGE™
Customer Information
Customer Name
*
First Name
Last Name
Customer Email
*
example@example.com
Practice Name
*
Practice Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Customer Phone Number
Dentsply Sirona Chairside Specialist
Please Select
Jean Crawshaw -BC
Joanne Hovey -BC
Michelle Boucher - BC
Jennifer Reyes - AB
Sheena Fiander-AB
Kristy Charlton -SK
Kylee Zylberman -MB
Lisia Malcolm -ON
Manny Gill -ON
Marc Pelletier -ON
Michael Hannan -ON
Paul Khazzaka -ON
Tabitha Thompson - ON
Tom Giftakopoulos -ON
Diane Bellemare -QC
Martin Durand -QC
Pier-Luc Boucher -QC
Rima Ambaraghassi - QC
Natalie Hayes -NS/NB/PEI/NFLD
Authorized Distributor
Please Select
Patterson Dental
Henry Schein
Sinclair Dental
K-Dental
Other
Dealer Representative Name:
First Name
Last Name
Invoice date
*
-
Month
-
Day
Year
Date
Invoice/ Order Number
*
Attach Invoice
*
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90741L01 Nupro® Freedom™ Cordless Prophy Package
740000 Nupro® RDH® Hygienist Handpiece forDisposable Angles
740020 Nupro® RDH® Hygienist Handpiece with Prophy Right Angle
780344 TRADITION TL W/ LEVER 4-HOLE
770344 TRADITION TC PUSH BUTTON SIRONA-STYLE
770445 TRADITION PRO TFC FIBER-OPTIC PUSH BUTTON KAVO-STYLE
780345 TRADITION PRO TLF FIBER-OPTIC LEVER 5-HOLE
790344 TRADITION TB PUSH BUTTON 4-HOLE
790345 TRADITION PRO TBF FIBER-OPTIC PUSH BUTTON 5-HOLE
791400 MIDWEST PHOENIX™ - MIDWEST BACKEND
791410 MIDWEST PHOENIX™ - SIRONA BACKEND
791420 MIDWEST PHOENIX™- NSK BACKEND
791430 MIDWEST PHOENIX™ - KAVO BACKEND
792400 MIDWEST STYLUS PLUS - MIDWEST BACKEND
792410 MIDWEST STYLUS PLUS - SIRONA BACKEND
792420 MIDWEST STYLUS PLUS - NSK BACKEND
792430 MIDWEST STYLUS PLUS - KAVO BACKEND
793400 MIDWEST PHOENIX™ ZR - MIDWEST BACKEND
793430 MIDWEST PHOENIX™ ZR - KAVO BACKEND
875045 MIDWEST E - ELECTRIC MOTOR ONLY
875101 MIDWEST E MINI 1:5 HIGH SPEED ATTACHMENT
875105 MIDWEST E PRO 1:5 HIGHSPEED ATTACHMENT
875110 MIDWEST E PRO 1:1 SLOWSPEED ATTACHMENT
875205 MIDWEST E PLUS 1:5 FO HIGH SPEED ATTACHMENT
875210 MIDWEST E PLUS 1:1 FO LOW SPEED ATTACHMENT
875230 MIDWEST E PLUS 1:1S FO STRAIGHT ATTACHMENT
884310 MIDWEST PHOENIX™ PRO- ATC BACKEND
875305 Midwest®T1 Energo S 1:5 L
875310 Midwest®T1 Energo S 1:1 L
875315 Midwest®T1 Energo 1:5 L
875320 Midwest®T1 Energo 1:1 L
875401 Midwest®T2 Energo Mini 1:5 L
875415 Midwest®T2 Energo 1:5 L
875420 Midwest®T2 Energo 1:1 L
644.50.020 SMARTLITE FOCUS INTRO PACKAGE
Terms & Conditions:
Purchases must be made on one invoice between 1/1/2025 and 3/31/2025. Purchases made as related to free products are strictly non-returnable for credit. Purchases for the above promotion does not qualify for any other Dentsply Sirona special programs. Dentsply Sirona Canada reserves the right to change or cancel these promotions at any time. Offers valid in Canada only. Free product fulfilled by Dentsply Sirona Customer Care. Free good request include proof of purchase must be submitted through this respective online form within 30 days after promotion end date.
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