Case Planning

Please allow ample time to enable us to give the level of work you deserve. This Schedule includes the pick-up and delivery. Weekends and holidays are not included. Cases involving attachments and specially ordered parts will be scheduled when the parts arrive. View Schedule

Please fill in the form below, or download the RX form and send back to us.

RX Form Computer Guided Surgery Implant Planning Prescription Form

Component Indentification

If you have a component which you cannot identify, click here to send it through to the team at Marotta Dental.

To submit a case through DDX Click Here

Doctor's Name

License #

Client Code

Phone Number

Alternate or Cell Number

Email Address

Patient's Name

Patient's Age

Gender

Case Number

Shade

Underlying Stump Shade

Restoration tooth #'s

Crown & Bridge

Implant One-Step

Denture

Case Description

Please enter a description below

Upload Files

Verfication Code

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