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M O Yale Dental, Inc 1 Seitz Lane Cos Cob, CT 06807 www 2026
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- Click ‘Get Form’ to open the document in the editor.
- Begin by entering your personal information in the designated fields: Name, Phone Number, Address, City, State, ZIP Code, and Email Address.
- Confirm that all instruments are sterilized by initialing in the provided space.
- Select any retipping or sharpening services you require by checking the appropriate boxes next to each service listed.
- For ultrasonic insert retipping service, indicate your frequency preference by selecting either 25k or 30k.
- Itemize your instruments in the provided section. Include comments and prices for each item as necessary.
- Calculate shipping costs based on the total number of instruments sent and enter this amount in the Total field.
- Choose your payment method by checking one of the options available and fill in any required details such as Billing Zip Code and CVV Code.
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