DentalMiles

DentalMiles Account Information

Email*

Password*

Confirm Password*

Clinic Name (English)*

Clinic Name (Chinese)

CONTACT PERSON'S INFORMATION

First Name*

Last Name*

Contact Number*

Please provide your customer code below for the migration of DentalMiles Account

Modern Dental Laboratory Code

Please contact +852 3766 0771 / +852 3766 0777 if you forget your Modern Dental Laboratory Code

Peak Dental Solutions Code

Please contact +852 2105 1088 if you forget your Peak Dental Solutions Code

Please confirm your information as below

Email

First Name*

Last Name*

Contact Number

Clinic Name (English)

Clinic Name (Chinese)

Business Address

Delivery Address

Same as Business Address

Telephone*

Fax

Office Hour

MONDAY to FRIDAY

from : to :

SATURDAY

from : to :

LUNCH TIME

from : to :

Document Submission

Scan and Upload your doctor business card

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Scan and upload your business registration copy

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