Create an Account

Registering for this site is easy. Just fill in the fields below, and we'll get a new account set up for you in no time.

Account Details

Profile Details

1) Name of Practice (required)

This field can be seen by: Only Me

Who can see this field?
2) Practice Address: (required)

This field can be seen by: Only Me

Who can see this field?
3) Prefered Contact Address (if different from above):

This field can be seen by: Only Me

Who can see this field?
4) Name of GDP & GDC number:

This field can be seen by: Only Me

Who can see this field?
5) Contact Numbers:* (required)

This field can be seen by: Only Me

Who can see this field?
8) Number of dental chairs:

This field can be seen by: Only Me

Who can see this field?
Name (required)

This field can be seen by: Everyone

9) Who recommended DPLtd to you or how did you hear about us:

This field can be seen by: Only Me

Who can see this field?
10) Dental Directory Acc No:

This field can be seen by: Only Me

Who can see this field?
11) Any Patient Plans:

This field can be seen by: Only Me

Who can see this field?
No of patients:

This field can be seen by: Only Me

Who can see this field?
Admin fee:

This field can be seen by: Only Me

Who can see this field?
Does it include Insurance:

This field can be seen by: Only Me

Who can see this field?
12) Who is your clinical waste with:

This field can be seen by: Only Me

Who can see this field?
13) Who do you have your Surgery Insurance with:

This field can be seen by: Only Me

Who can see this field?
14) Have you completed your Decontamination rooms yet:

This field can be seen by: Only Me

Who can see this field?
15) Are you currently a member of any other group:

This field can be seen by: Only Me

Who can see this field?
16) What dental software do you currently use?

This field can be seen by: Only Me

Who can see this field?
17) Do you offer an implant service to your patients?

This field can be seen by: Only Me

Who can see this field?
18) What implant service do you use? And would you be interested in considering a saving on an implant Kit, implants and the added products?

This field can be seen by: Only Me

Who can see this field?
19) Who do you have you Radiation Protection Service with:

This field can be seen by: Only Me

Who can see this field?
I agree to become a member of Dental Professionals Limited (DPL). Membership is free and I agree that Dental Professionals Limited may use our practic

This field can be seen by: Only Me

Who can see this field?
Agree to Terms (required)

Once your membership is approved, Dental Professionals Limited will share your details with its selected suppliers so that they may inform you about their products, prices and any special offers. This will also help DPLtd to enhance our preferential arrangements.

This field can be seen by: Everyone

Who can see this field?
Signed (required)

This field can be seen by: Only Me

Who can see this field?
Date (required)

This field can be seen by: Only Me

Who can see this field?