AllPro On Line Order Form for Disposable Prophy Angles with Brushes

AllPro On Line Order Forms All-Dri™ Cotton Pads All-Wipe™ Instrument Cleaner Disposable Prophy Angles with » Prophy Cups » Brushes » Pointed Polishers Interdental Travel Brushes Non-Latex Prophy Cups » Latch Mandrel » Screw Type » Snap-On Pedo Products Pro-Paste™ Prophy Paste Prophy Brushes » Screw Type » Snap-On » Metal, Screw Type Protect-A-Lens Protective Eyewear

Disposable Prophy Angles with Brushes On Line Order Form
Individually wrapped disposable prophy angles with tapered brushes are available in dispenser boxes of 100 or 500.

Indicate how many of each you wish to order in the "Qty" column. The total amount of your order will be calculated automatically. When you are ready to submit your order, click on the Make Purchase button.

Qty	Part #	Description	Price	Total
	810	Disposable Prophy Angle with Tapered Brush, White Nylon Bristles, Dispenser Box of 100	$59.00
	810-R	Disposable Prophy Angle with Tapered Brush, White Nylon Bristles, Refill Box of 500	$280.00
			GRAND TOTAL:

Name of dental office, school or dealer

Ordered by

Phone Number

E-mail Address

Ship to Address

Bill to Address

Dealer you prefer to use, if known

(Please call AllPro at 1-800-243-2285 if you need the name of a dealer)

Dealer Purchase Order Number