Get Started With Your Doctor Profile

Please attach your completed Doctor Preferences to the form or email it to info.becden@microdental.com.

Doctor Preference Form

New Account Authorization & Agreement

Customer shall pay for the products ordered pursuant to the payment terms of net 30 days from the date of the invoice or as otherwise stated on each invoice. Customer agrees to pay the amount of any taxes resulting from purchases. If payment is not made to MicroDental in accordance with the payment terms set forth, MicroDental may add a 1.5% finance charge per month for any unpaid balance and the Customer shall be liable to MicroDental for all reasonable attorney fees and costs incurred by MicroDental to effect collection of any invoice unpaid in whole or part. In addition, MicroDental reserves the right to suspend all future shipments until all payments have been received. Applicant’s signature attests financial responsibility, ability, and willingness to pay invoices in accordance with the agreement terms and asserts authority to apply for this account.