America's largest denture repair service.
ORDER FORM Questions? 1-401-725-5777
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 $30.
Mail to: Denture Repair Lab | 541 Newport Ave | Pawtucket RI 02861
Customer Information
First Name*
Last Name*
Phone*
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Address*
Apt#*
City
State
Zip Code
Money Order
Credit Card #
Expiration /
3 Digit Code
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.
Denture Repair / Partial Repair
1 Crack/Fracture $119.00
2 Cracks/Fractures $179.00
3 Cracks/Fractures $269.00
Rebuild Area w/ Acrylic $249.00
Duplicate Denture $499.00
Duplicate Partial $549.00
Glue Removal $35.00
Metal Reinforcement $35.00
Professional Cleaning $69.00
90 Day Warranty $65.00
Denture Teeth Repair
1 Tooth (you supply) $115.00
2 Teeth (you supply) $175.00
3 Teeth (you supply) $235.00
Duplicate Denture $499.00
1 Tooth (lab supply) $135.00
2 Teeth (lab supply) $215.00
3 Teeth (lab supply) $295.00
Duplicate Partial $549.00
Glue Removal $35.00
Metal Reinforcement $35.00
Professional Cleaning $69.00
90 Day Warranty $65.00
Flexible Partial Repair
1 Crack/Fracture $249.00
2 Cracks/Fractures $289.00
Duplicate Partial $449.00
1 Tooth (you supply) $185.00
2 Teeth (you supply) $235.00
1 Tooth (lab supply) $205.00
2 Teeth (lab supply) $265.00
Glue Removal $35.00
Metal Reinforcement $35.00
Professional Cleaning $69.00
90 Day Warranty $65.00
Duplicate Denture / Duplicate Partial
Duplicate Denture $499.00
Duplicate Partial $549.00
Duplicate Hard Nightguard $399.00
1Shade Whitter Teeth $35.00
Professional Cleaning $69.00
90 Day Warranty $65.00
Additional Instructions
Coupon Code
Please mail your denture to:
Denture Repair Lab
541 Newport Ave
Pawtucket RI 02861
Total
Please DO NOT send in valuable to you containers along with your dentures/partials, since it will not be returned.