- Synergy Dental Partners

(888) 810-2995

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About Us

Membership is FREE

On behalf of all of us at Synergy Dental Partners, we would like to say welcome to our firm.

Our Group Purchasing Membership is completely FREE and allows your dental office to realize the benefits of group purchasing immediately. As a member of Synergy, your office will benefit from cost saving agreements made between Synergy and respective distributors and vendors.

Please fill out the web form below or print and fill out the .PDF form and fax to (888) 487-9791 or e-mail to sales@thesynergydentalpartners.com so that we can start achieving savings for your office immediately.
Name of Dental Office*
Doctor's Name*
Prefix First Last
Dental License Number*
What is your field of dentistry?*
Office Address*
Street Address Address Line 2 City State ZIP Code
Do You Have More Than 1 Office?
Office Address 2
Street Address Address Line 2 City State ZIP Code
Do You Have More Than 2 Offices?
Office Address 3
Street Address Address Line 2 City State ZIP Code
Do You Have More Than 3 Offices?
Office Address 4
Street Address Address Line 2 City State ZIP Code
Do You Have More Than 4 Offices?
Office Address 5
Street Address Address Line 2 City State ZIP Code
Primary Contact Name*
First Last
Primary Contact Email*
Primary Phone*
Will the Primary Contact also be ordering supplies?*
- Yes
- No
Name of Person Ordering Supplies*
First Last
Phone of Person Ordering Supplies*
Email of Person Ordering Supplies*
Fax Number
Are you currently a customer of Darby Dental?*
Darby Account Number
How did you hear about Synergy Dental Partners?*
Questions/Comments:
*
- I have read the disclosure agreement:
Disclosure Agreement
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