America's largest denture repair service.

ORDER FORM
Questions? 1-888-349-6695
Complete order form and click print button to print out the form. Credit card information is optional we can obtain it over the phone once denture is recieved. Shipping is free with prepaid label. Overnight shipping is suggested. We ship back with free USPS Priority mail. Upgrade to USPS Express for $25. Attention: Our Lab and Customer Services department will be temporarily closed July 3 thru July 10, 2017. This allows us and our employees to attend annual professional development and training seminars. Dentures received on July 3, 2017 thru July 10, 2017 will be repaired and sent back on July 11. We apologize for any inconvenience this may cause. Please plan accordingly.
Mail to: Denture Repair Lab | 541 Newport Ave | Pawtucket RI 02861    


First Name  Last Name    Phone   - - *
Address     Apt# 
City     State      Zip Code  -
Email  
          Money Order     
Credit Card #    Expiration /   3 Digit Code
 
Signature:___________________________________________    
I have read and agree to the Denture Repair Lab Policy and authorize Denture repair Lab to charge my credit card for the services provided.

Glue Removal $29.00     Metal Reinforcement $29.00   Rebuild Gum Area w/ New Acrylic $189.00
1 Crack/Break/Fracture     $89.00
2 Cracks/Breaks/Fractures $125.00
3 Cracks/Breaks/Fractures $155.00
Duplicate Denture $349 / Duplicate Partial $399.00
Professional Cleaning & Polishing $49.00
90 Day Warranty $45.00

Glue Removal $29.00     Metal Reinforcement $29.00  Rebuild Gum Area w/ New Acrylic $189.00
1 Tooth (you supply tooth) $95.00
2 Teeth (you supply teeth) $135.00
3 Teeth (you supply teeth) $185.00
1 Tooth ( lab supply teeth) $115.00
2 Teeth (lab supply teeth) $185.00
3 Teeth (lab supply teeth) $225.00
Duplicate Denture $349 / Partial $399.00  Cleaning /Polishing $49.00 90 Day Warranty $45.00

Glue Removal $29.00     Metal Reinforcement $29.00
1 Crack/Break/Fracture $219.00
2 Cracks/Breaks/Fractures $259.00
1 Tooth (you supply) $185.00
2 Teeth (you supply) $215.00
1 Tooth (lab supply) $205.00
2 Teeth (lab supply) $235.00
Duplicate Partial $399.00     Cleaning & Polishing $49.00   90 Day Warranty $75.00
Duplicate Denture  $349.00
Duplicate Partial (non metal) $399.00
Duplicate Hard Nightguard $349.00
1Shade Whitter Teeth $35.00
Cleaning & Polishing $49.00
90 Day Warranty $45.00
Additional Instructions
Coupon Code
TOTAL
Please mail your denture to:
Denture Repair Lab
541 Newport Ave
Pawtucket RI 02861

Please DO NOT send in your denture boxes, dental containers or any other containers along with your dentures/partials, since it will not be returned due to shipping weight restrictions.