LuxaCrown Order RequestPlease enable JavaScript in your browser to complete this form.Order LuxaCrown today!LuxaCrown, the revolutionary high-performance material, creates long-lasting crowns quickly and economically - directly chairside. The easy-to-make long-term composite crown is highly esthetic and shows remarkable longevity. It is ideal for crown and bridge work and implant procedures where phasing of treatment is recommended. LuxaCrown offers the confidence and natural beauty at a less-costly option for your patients while delivering the high strength, quality and reliability you’ve come to expect from DMG.Place your order of LuxaCrown and start discovering the possibilities for you and your patients.Name *FirstLastPractice Name *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Phone *I am a ... *- Select One -DentistDental PracticeDealerStudentOtherTitle *- Select One -DentistDental AssistantDental HygienistOwner/ManagerOffice ManagerOtherDealer *DMG Rep or Referring ClinicianProduct SelectionShadeLuxaCrown - 1-50 ml Cartridge, 15 Automix-Tips - Shade A1 (item# 120970)Quantity *ShadeLuxaCrown - 1-50 ml Cartridge, 15 Automix-Tips - Shade A2 (item# 120971)Quantity *ShadeLuxaCrown - 1-50 ml Cartridge, 15 Automix-Tips - Shade A3 (item# 120972)Quantity *ShadeLuxaCrown - 1-50 ml Cartridge, 15 Automix-Tips - Shade A3.5 (item# 120973)Quantity *ShadeLuxaCrown - 1-50 ml Cartridge, 15 Automix-Tips - Shade B1 (item# 120974)Quantity *Additional Order NotesFor Internal Use OnlyWas order placed by dealer?YesNoBy clicking submit, you agree to receive periodic emails from DMG Connect and DMG. You have the option of unsubscribing at any time.NameSubmit
