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Dental Trauma UK - Saving injured teeth
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Join Dental Trauma UK

To apply to become a member of Dental Trauma UK complete the form below. When the form is complete you'll be redirected to our secure payment provider so that you can pay the membership fee by credit card.

About you

Your title: *

Your first name: *

Your surname: *

Your practice name: *

Your primary contact details

Address line 1: *

Address line 2: (Optional)

Address line 3: (Optional)

City / Town: *

County / State / Region: (Optional)

Postal / ZIP code: *

Country: *

Your email address and telephone number

Your email address: *

Confirm your email address: *

Your telephone number: *

Your password

Your password: (Must contain between 5-15 characters) *

Additional information

Please select your occupation: *

GDC number: *

Year primary dental qualification obtained: *

Practice types: (Add all that apply)
 

Offer code: (Optional)
 

Cost (£):
30.00

Make payment

Cardholder name: *

Is the cardholder address the same as the primary address?

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Data protection and secuity

Although member details are not encrypted by our website, all payments made via our site are transacted via the secure WorldPay platform.

To find out about...

To find out how to contact us and get details of our cancellation policy click the terms and conditions link at the bottom of our site. You can contact the online sales administrator by email at info@dentaltrauma.co.uk.

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