smilessence teeth whitening systems
product information order here become a distributor

Welcome and thank you for inquiring about distributor opportunities. We are committed to making your profit margins grow with our Smilessence Teeth Whitening products. Our product is a hot seller in the dental industry today and distributing it in your area is easy and profitable.

Professional strength teeth whitening gel with custom fitted trays are the most effective way to whiten teeth today, and now we are making it available to the public via your dental practice.

To receive information on dealer terms and pricing fill out the following form and Smilessence we will mail dealer information to you.


Dentist's Order Form
*Company Name:


*Dental License:


*Contact Name:

Position

*Address


*Telephone Number

Fax Number

*Email Address

Expected Annual Order Volume
1 case (12 Smilessence Kits)
2 cases (24 Smilessence Kits)
3-4 cases (36-48 Smilessence Kits)

When do you expect to place your first order?
1-3 months   3-6 months   6-12 months   Over 12 months

Notes, Questions, & Comments