terms agreement which we must have on file for all clients ... · rebase, reline & repair...

1
Customer Preferences Kuwata Pan Dent 185 Ridgedale Avenue, Cedar Knolls, NJ 07927 Tel: 877.377.4455 • Fax: 973.540.0711 [email protected] ® ® (e.max and translucent zirconia require a stump shade) The Laboratory Dentists Trust since 1976

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Page 1: Terms Agreement which we must have on file for all clients ... · Rebase, reline & repair service Scanning appliances Su gical sten tcs® and Valplast® CROWN AND BRIDGE P orc e lain

Customer Preferences

ALL CERAMIC CROWN AND BRIDGE ALL IMPLANT SYSTEMS ®

e.max crowns, veneers, inlays & onlays Porcelain fused to metal Custom abutments ® ™

Empress crowns & veneers 96% gold • Atlantis ™

Feldspathic veneers CAD milled • Bellatek ™ ®

Lava crowns & bridges Full cast gold • Encode Full contour zirconia crowns • Crowns prepped

® ™

Procera crowns & bridges • Inlays • Lava ®

• Alumina • Onlays • Procera ®

• Zirconia • Straumann DENTURES AND ACRYLIC PROVISIONALS OVERDENTURES Essix retainers Heat-processed provisionals Highwater fixture level Flippers Cast reinforcement ERA Full & partial dentures Implant provisionals Locator

® ®

Ivocap or Lucitone 199 Transitional partials Milled titanium Hader bar Nightguards Other implant systems Rebase, reline & repair service DIAGNOSTICS Straumann scanning appliance Case planning Surgical stents Orthodontic

® ®

tcs and Valplast Showcase presentation

NOW SUPPORTING ™

DIGITAL IMPRESSION SYSTEM: iTero and 3M GUIDED SURGERY: Nobel Clinician, Straumann & Biohorizon

® ™

CHAIRSIDE CONVERSION: Biomet3i DIEM , Nobel All on 4 and other Immediate Full Arch Rehabilitation

At Kuwata Pan Dent, we believe that communication is the key to restorative success. The demand for healthy, natural-looking teeth requires significant planning on the part of the

restorative team. We are prepared to assist you with every phase, from diagnostic wax up and temporization through insertion. We can provide surgical stents for implant placement, assistance with implant hardware selection, make suggestions regarding restorative options and even provide

preparation, impression taking and cementation information. Just let us know how we can help. All Restorations Proudly Made in the USA

ALL CERAMIC

e.max® crowns, veneers, inlays & onlays Feldspathic veneers Porcelain fused to zirconia C&B Solid zirconia crowns Zirconia occlusal with feldspathic veneer

DENTURES AND ACRYLIC

Essix retainers Flippers Full & partial dentures Ivocap® Nightguards Rebase, reline & repair service Scanning appliances Surgical stents tcs® and Valplast®

CROWN AND BRIDGE

Porcelain fused to metal • 2.5%, 54%, 86% gold • Non precious CAD milled

Full cast gold • Crowns • Inlays • Onlays

PROVISIONALS

Custom milled provisionals Cast reinforcement Implant provisionals Transitional partials

DIAGNOSTIC WAX UP

Case planning Showcase presentation

ALL IMPLANT SYSTEMS

Custom abutments • Atlantis™ • Encode® • Lab cast or prepped • Neoss • Nobel Procera® • Straumann® • Zimmer Biomet

OVERDENTURES

Highwater fixture level ERA Locator Milled titanium Hader bar All Implant Systems

NOW SUPPORTING DIGITAL IMPRESSION SYSTEMS: We accept digital files directly from all open architecture systems GUIDED SURGERY: coDiagnostiX™ and NobelClinician™ CHAIRSIDE CONVERSION: Nobel All on 4™and other Immediate Full Arch Rehabilitations

At Kuwata Pan Dent, we believe that communication is the key to restorative success. The demand for healthy, natural-looking teeth requires significant planning on the part of the restorative

team. We are prepared to assist you with every phase, from diagnostic wax up and temporization through insertion. We can provide surgical stents for implant placement, assistance with implant

hardware selection, make suggestions regarding restorative options and even provide preparation, impression taking and cementation information. Just let us know how we can help.

All Restorations Proudly Made in the USA

185 Ridgedale Avenue, Cedar Knolls, NJ 07927 Tel: 877.377.4455 • Fax: 973.540.0711 [email protected]

The laboratory dentists trust since 1976

Directory of Products and Services

ALL CERAMIC CROWN AND BRIDGE ALL IMPLANT SYSTEMS®

e.max crowns, veneers, inlays & onlays Porcelain fused to metal Custom abutments® ™

Empress crowns & veneers • 2.5%, 54%, 86%, 96% gold • Atlantis™

Feldspathic veneers CAD milled • Bellatek™ ®

Lava crowns & bridges Full cast gold • EncodeFull contour zirconia crowns • Crowns • Lab cast or prepped

® ™

Procera crowns& bridges • Inlays • Lava®

• Alumina • Onlays • Procera®

• Zirconia • Straumann

DENTURES AND ACRYLIC PROVISIONALS OVERDENTURESEssix retainers Heat-processed provisionals Highwater fixture levelFlippers Cast reinforcement ERAFull & partial dentures Implant provisionals Locator

® ®

Ivocap orLucitone 199 Transitional partials Milled titanium Hader barOther implant systems

Rebase, reline & repair service DIAGNOSTICSStraumann scanning appliance Case planningSurgical stents Orthodontic

® ®

tcs and Valplast Showcase presentation

NOW SUPPORTING™

DIGITAL IMPRESSION SYSTEM: iTero and 3MGUIDED SURGERY:

® ™

CHAIRSIDE CONVERSION:

At Kuwata Pan Dent, we believe that communication is the key to restorative success.The demand for healthy, natural-looking teeth requires significant planning on the part of the

restorative team. We are prepared to assist you with every phase, from diagnostic wax up andtemporization through insertion. We can provide surgical stents for implant placement, assistance with implant hardware selection, make suggestions regarding restorative options and even provide

preparation, impression taking and cementation information. Just let us know how we can help.

All Restorations Proudly Made in the USA

ALL CERAMIC

e.max® crowns, veneers, inlays & onlays Empress® crowns & veneersFeldspathic veneersPorcelain fused to zirconia C&B Solid Full contour zirconia crownsHybrid Zr Zirconia occlusal with feldspathic veneer

DENTURES AND ACRYLIC

Essix retainers FlippersFull & partial dentures Ivocap®NightguardsRebase, reline & repair service Scanning appliancesSurgical stents tcs® and Valplast®

CROWN AND BRIDGE

Porcelain fused to metal• 2.5%, 54%, 86%, 96% gold• Non precious CAD milled

Full cast gold2.5%, 54%, 56% gold

• Crowns• Inlays• Onlays

PROVISIONALS

Custom milled provisionals Cast reinforcement Implant provisionals Transitional partials

DIAGNOSTIC WAX UP

Case planningOrthodonticShowcase presentation

ALL IMPLANT SYSTEMS

Custom abutments• Atlantis™• Encode®• Lab cast or prepped• Neoss• Nobel Procera®• Straumann®• Zimmer Biomet

OVERDENTURES

Highwater fixture levelERALocatorMilled titanium Hader bar All Implant Systems

NOW SUPPORTINGDIGITAL IMPRESSION SYSTEMS: We accept digital files directly from all open architecture systemsGUIDED SURGERY: coDiagnostiX™ and NobelClinician™CHAIRSIDE CONVERSION: Nobel All on 4™and other Immediate Full Arch Rehabilitations

At Kuwata Pan Dent, we believe that communication is the key to restorative success.The demand for healthy, natural-looking teeth requires significant planning on the part of the restorative

team. We are prepared to assist you with every phase, from diagnostic wax up and temporization through insertion. We can provide surgical stents for implant placement, assistance with implant

hardware selection, make suggestions regarding restorative options and even provide preparation, impression taking and cementation information. Just let us know how we can help.

185 Ridgedale Avenue, Cedar Knolls, NJ 07927 Tel: 877.377.4455 • Fax: [email protected]

The laboratory dentists trustsince 1976

Directory of Products and Services

Kuwata Pan Dent185 Ridgedale Avenue, Cedar Knolls, NJ 07927Tel: 877.377.4455 • Fax: [email protected]

This case wasmanufactured in a

CERTIFIEDDENT AL

®

ikuzo_Tsutomu Nozawa 11/17/14 12:04 PM Page 1

®

KUWATA PAN DENT

(e.max and translucent zirconia require a stump shade)

Thank you for choosing Kuwata Pan Dent, the laboratory dentists trust. This is our standard Payment and Terms Agreement which we must have on file for all clients. By reviewing, signing, indicating your preferred payment method and returning the form to us, you are agreeing to the payment terms described below in detail.

An invoice is provided with every case, detailing the products ordered and associated fees. In addition, a monthly statement is mailed listing all outstanding invoices. Please pay from the statement. Payment is due within 20 days of the statement date.

If payment is not received as stated above, a 1.5% monthly finance charge will be assessed on the account balance. We cannot accept payment directly from your patients and we cannot hold a balance open while you are waiting for your patient to pay you.

For any balance over 60 days, the account will be placed on a C.O.D. basis.

Please return this completed form by email ([email protected],) fax (973-540-0711) or mail. If you have any questions or concerns regarding this agreement, please contact Lisa Cariddi at 877-377-4455 x128.

Doctor’s Name License #

Doctor’s Signature Date

Kuwata Pan Dent185 Ridgedale Avenue, Cedar Knolls, NJ 07927 Tel: 877.377.4455 • Fax: [email protected]

QF 4.3-CRD, Rev 12

The Laboratory Dentists Trustsince 1976

Payment MethodPlease check preferred payment method.

Check for balance

Ship cases C.O.D.

Credit Card: (American Express, Visa, MasterCard, Discover)

o Automatically charge on the 20th of the month based on statement total.

o Will phone in before the 20th of each month

Billing PolicyExcept in the case of obvious lab error, it is our policy to evaluate each remake independently and charge accordingly.

Kuwata Pan Dent will rework or remake any case to the customer’s satisfaction at no additional charge if returned to the laboratory within 30 days from the date of delivery. If the remake involves new impressions, models, bites or changes to the original prescription,orif a lab request for additional impressions, models, bites, etc. is denied, remake charges will apply.

Prices are subject to change without notice.