Dental Junior

Online Order

You can simply fulfill your order online through our online form. We will send you a printed copy of your filled out contract the next day. Sign the received contract and return it to us in the enclosed envelope.

Personal informaton

Anamnesis

Confirmation

Banking for 20 years

Additional options

Price 2590

VAT is included in the price, the membership fee is included in the final price.

Donor center

Your child's information

Please enter name.
Please enter last name.
Please enter your address.
Please enter postal code and town.
Please enter Unique Master Citizen Number.

Child’s legal guardian information

Please enter name.
Please enter last name.
Please enter your address.
Please enter postal code and town.
Please enter Unique Master Citizen Number.
Please enter your phone number.
Please enter your e-mail.