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Update Existing Case

Patient First and Last name*

Dr.name*

Email address*

Phone number

Change Delivery Date

Request To Rush the case(35% Rush fee May Apply)

Note

Upload Picture

Change Fixed Restoration Type

Change Teeth Shade (VITA Classic)

Change Removable Restoration Type

Change Restoration Quality

Change Gum Shade

Check this Box To cancel the existing case

Check This Box To place your case on hold

Request Case Pickup

Request Case Pickup

Submit a New Case

Patient First and Last name*

Dr . Name*

Email address

Phone number*

Delivery Date:

Request to Rush Your Case (35% Rush Fee May Apply )

Note

Upload Case Picture

Teeth Shade

Fixed Restoration Type

Removable Restoration Type

Restoration Quality

Gum Shade

Check This box if you would like us to call you after we receive your case

Check This box to Schedule Pickup

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Time

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Address

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remake & refund policy

Contact US

Office : 586-243-6209

ankadentallab@hotmail.com

33975 Dequindre Rd suite 108, Troy, MI 48083

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