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Company Name*
Your Position
Company Website
Contact phone & extension*
Contact Email*
Number of offices*
Average number of doctors per office*
Checkmarks to indicate types of practice management software used (and allow for multiple marks)
- Dentrix
- Eaglesoft
- CS PracticeWorks
- CS SoftDent
- QSI Dental
- Curve
- Open Dental
- Other(s) - Specify
Indicate other type of practice management software used*
Comments
This field is for validation purposes and should be left unchanged.