RX Forms

Fill out RX forms online and print them out instantly. (Recommended)

CROWN AND BRIDGE Rx

REMOVABLE RESTORATIONS Rx

Print and hand-write RX (Must print legibly and include your account number to avoid any delays)

PRINTABLE Rx FORM

ATTENTION: Any incomplete or unreadable Rx will delay the case.

PFM

$25

Zirconia

$34

EMAX

$40

Full Denture

$55

Free Shipping*

(Round Trip)

Year Round Prices

(no minimum)

3 Year Warranty

(Crown & Bridge)
Full Price List
*For USA accounts only (except Alaska and Hawaii). Up to 20 monthly shipping fees will be credited, for every monthly statement of $3500 or more (excluding shipping fees)

  • Shipping Chart

    State UPS Service Destination Time
    Alabama Ground Florida 2 Days
    Alaska Call for Pricing
    Arizona Ground California 2 Days
    Arkansas Ground Texas 2 Days
    California Ground California 1 to 2 Days
    Colorado 2nd Day Air Texas 2 Days
    Connecticut 2nd Day Air Florida 2 Days
    Delaware 2nd Day Air Florida 2 Days
    Florida Ground Florida 1 to 2 Days
    Georgia Ground Florida 2 Days
    Hawaii Call for Pricing
    Idaho 2nd Day Air California 2 Days
    Illinois 2nd Day Air Texas 2 Days
    Indiana 2nd Day Air Florida 2 Days
    Iowa 2nd Day Air Texas 2 Days
    Kansas 2nd Day Air Texas 2 Days
    Kentucky Ground Florida 2 Days
    Louisiana 2nd Day Air Texas 2 Days
    Maine 2nd Day Air Florida 2 Days
    Maryland 2nd Day Air Florida 2 Days
    Massachusetts 2nd Day Air Florida 2 Days
    Michigan 2nd Day Air Florida 2 Days
    Minnesota 2nd Day Air Texas 2 Days
    Mississippi Ground Texas 2 Days
    Missouri 2nd Day Air Texas 2 Days
    Montana 2nd Day Air California 2 Days
    Nebraska 2nd Day Air Texas 2 Days
    Nevada Ground California 1 to 2 Days
    New Hampshire 2nd Day Air Florida 2 Days
    New Jersey 2nd Day Air Florida 2 Days
    New Mexico 2nd Day Air Texas 2 Days
    New York 2nd Day Air Florida 2 Days
    North Carolina Ground Florida 2 Days
    North Dakota 2nd Day Air Texas 2 Days
    Ohio 2nd Day Air Florida 2 Days
    Oklahoma Ground Texas 2 Days
    Oregon 2nd Day Air California 2 Days
    Pennsylvania 2nd Day Air Florida 2 Days
    Puerto Rico Call for Pricing
    Rhode Island 2nd Day Air Florida 2 Days
    South Carolina Ground Florida 2 Days
    South Dakota 2nd Day Air Texas 2 Days
    Tennessee Ground Florida 2 Days
    Texas 2nd Day Air Texas 2 Days
    Utah Ground California 2 Days
    Vermont 2nd Day Air Florida 2 Days
    Virginia Ground Florida 2 Days
    Washington 2nd Day Air California 2 Days
    West Virginia 2nd Day Air Florida 2 Days
    Wisconsin 2nd Day Air Texas 2 Days
    Wyoming 2nd Day Air California 2 Days

  • Option 2: Standard

    State UPS Service Destination Time
    Alabama Ground Florida 2 Days
    Alaska Call for Pricing
    Arizona Ground California 2 Days
    Arkansas 2nd Day Air Florida 2 Days
    California Ground California 1 to 2 Days
    Colorado 2nd Day Air California 2 Days
    Connecticut 2nd Day Air Florida 2 Days
    Delaware 2nd Day Air Florida 2 Days
    Florida Ground Florida 1 to 2 Days
    Georgia Ground Florida 2 Days
    Hawaii Call for Pricing
    Idaho 2nd Day Air California 2 Days
    Illinois 2nd Day Air Florida 2 Days
    Indiana 2nd Day Air Florida 2 Days
    Iowa 2nd Day Air Florida 2 Days
    Kansas 2nd Day Air Florida 2 Days
    Kentucky Ground Florida 2 Days
    Louisiana 2nd Day Air Florida 2 Days
    Maine 2nd Day Air Florida 2 Days
    Maryland 2nd Day Air Florida 2 Days
    Massachusetts 2nd Day Air Florida 2 Days
    Michigan 2nd Day Air Florida 2 Days
    Minnesota 2nd Day Air Florida 2 Days
    Mississippi 2nd Day Air Florida 2 Days
    Missouri 2nd Day Air Florida 2 Days
    Montana 2nd Day Air California 2 Days
    Nebraska 2nd Day Air Florida 2 Days
    Nevada Ground California 1 to 2 Days
    New Hampshire 2nd Day Air Florida 2 Days
    New Jersey 2nd Day Air Florida 2 Days
    New Mexico 2nd Day Air California 2 Days
    New York 2nd Day Air Florida 2 Days
    North Carolina Ground Florida 2 Days
    North Dakota 2nd Day Air Florida 2 Days
    Ohio 2nd Day Air Florida 2 Days
    Oklahoma 2nd Day Air Florida 2 Days
    Oregon 2nd Day Air California 2 Days
    Pennsylvania 2nd Day Air Florida 2 Days
    Rhode Island 2nd Day Air Florida 2 Days
    South Carolina Ground Florida 2 Days
    South Dakota 2nd Day Air Florida 2 Days
    Tennessee Ground Florida 2 Days
    Texas 2nd Day Air Florida 2 Days
    Utah Ground California 2 Days
    Vermont 2nd Day Air Florida 2 Days
    Virginia Ground Florida 2 Days
    Washington 2nd Day Air California 2 Days
    West Virginia 2nd Day Air Florida 2 Days
    Wisconsin 2nd Day Air Florida 2 Days
    Wyoming 2nd Day Air California 2 Days

  • Option 1: Economy

    State UPS Service Destination Time
    Alabama Ground Florida 2 Days
    Alaska Call for Pricing
    Arizona Ground California 2 Days
    Arkansas Ground Texas 1 to 2 Days
    California Ground California 1 to 2 Days
    Colorado Ground California 3 Days
    Connecticut Ground New York 1 Day
    Delaware Ground New York 1 Day
    Florida Ground Florida 1 to 2 Days
    Georgia Ground Florida 2 Days
    Hawaii Call for Pricing
    Idaho Ground California 2 to 3 Days
    Illinois Ground Texas 2 to 3 Days
    Indiana Ground New York 2 to 3 Days
    Iowa Ground Texas 2 to 3 Days
    Kansas Ground Texas 1 to 2 Days
    Kentucky Ground Florida 2 Days
    Louisiana Ground Texas 1 to 2 Days
    Maine Ground New York 2 Days
    Maryland Ground New York 1 Day
    Massachusetts Ground New York 1 Day
    Michigan Ground New York 2 Days
    Minnesota Ground Texas 3 Days
    Mississippi Ground Texas 2 Days
    Missouri Ground Texas 2 Days
    Montana Ground California 3 to 4 Days
    Nebraska Ground Texas 2 to 3 Days
    Nevada Ground California 1 to 2 Days
    New Hampshire Ground New York 2 Days
    New Jersey Ground New York 1 Day
    New Mexico Ground California 3 Days
    New York Ground New York 1 Day
    North Carolina Ground Florida 2 Days
    North Dakota Ground Texas 3 Days
    Ohio Ground New York 2 Days
    Oklahoma Ground Texas 1 to 2 Days
    Oregon Ground California 2 to 3 Days
    Pennsylvania Ground New York 1 to 2 Days
    Rhode Island Ground New York 1 Day
    South Carolina Ground Florida 2 Days
    South Dakota Ground Texas 3 Days
    Tennessee Ground Florida 2 Days
    Texas Ground Texas 1 to 2 Days
    Utah Ground California 2 Days
    Vermont Ground New York 2 Days
    Virginia Ground Florida 2 Days
    Washington Ground California 3 Days
    West Virginia Ground New York 2 Days
    Wisconsin Ground Texas 3 Days
    Wyoming Ground California 2 to 3 Days